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尼泊尔中部皮肤结核的临床组织学特征

Clinicohistological Profile of Cutaneous Tuberculosis in Central Nepal.

作者信息

Mathur M, Pandey S N

机构信息

Department of Dermatology College of Medical Sciences- Teaching Hospital Bharatpur, Chitwan, Nepal.

出版信息

Kathmandu Univ Med J (KUMJ). 2014 Oct-Dec;12(48):238-41. doi: 10.3126/kumj.v12i4.13727.

Abstract

BACKGROUND

There are few studies on cutaneous tuberculosis in Nepal.

OBJECTIVE

To analyse the epidemiological, clinical and histological patterns of cutaneous TB over the past 5 years.

METHOD

Patients with cutaneous tuberculosis diagnosed from January 2010 to December 2014 at College of Medical Sciences, Chitwan, Nepal were included in the study. Chest radiography, routine investigations and screening for HIV was performed in all cases.

RESULT

A total of 47 clinical cases of cutaneous tuberculosis were diagnosed. The most commonly affected age group was 41-50 years. Male to female ratio was 1.5:1. Duration of cutaneous tuberculosis ranged from 1 month to 33 years. Lupus vulgaris was the most common clinical type (64%), followed by tuberculosis verrucosa cutis (19%). Two cases (4%) were diagnosed as papulonecrotic tuberculid. Overall, the most common site of involvement was extremities (55%) followed by head and neck, trunk, and perianal region. Histopathologic features of epitheloid cell granuloma with Langhans type giant cells were seen in 89% of cases, and in remaining 11% cases, chronic inflammatory dermatitis and nonspecific chronic dermatitis were observed.

CONCLUSION

M Tuberculosis is endemic in Nepal and the incidence of cutaneous tuberculosis at our centre was 0.1%. Lupus vulgaris was the most common type followed by tuberculosis verrucosa cutis in our study. Cutaneous tuberculosis can be accompanied by tuberculosis in internal organs and hence should be looked for. Clinicopathologic correlation is necessary to make a proper diagnosis.

摘要

背景

尼泊尔关于皮肤结核的研究较少。

目的

分析过去5年皮肤结核的流行病学、临床和组织学模式。

方法

纳入2010年1月至2014年12月在尼泊尔奇特旺医学科学院诊断为皮肤结核的患者。所有病例均进行胸部X线摄影、常规检查及HIV筛查。

结果

共诊断出47例皮肤结核临床病例。最常受累的年龄组为41 - 50岁。男女比例为1.5:1。皮肤结核病程从1个月至33年不等。寻常狼疮是最常见的临床类型(64%),其次是疣状皮肤结核(19%)。2例(4%)被诊断为丘疹坏死性结核疹。总体而言,最常受累部位是四肢(55%),其次是头颈部、躯干和肛周区域。89%的病例可见上皮样细胞肉芽肿伴朗汉斯巨细胞的组织病理学特征,其余11%的病例观察到慢性炎症性皮炎和非特异性慢性皮炎。

结论

结核分枝杆菌在尼泊尔为地方病,我们中心皮肤结核的发病率为0.1%。在我们的研究中,寻常狼疮是最常见的类型,其次是疣状皮肤结核。皮肤结核可伴有内脏结核,因此应予以排查。进行准确诊断需要临床病理相关性分析。

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