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皮肤结核病:在巴西圣埃斯皮里图州维多利亚市结核病流行地区的一项26年回顾性研究

CUTANEOUS TUBERCULOSIS: A 26-YEAR RETROSPECTIVE STUDY IN AN ENDEMIC AREA OF TUBERCULOSIS, VITÓRIA, ESPÍRITO SANTO, BRAZIL.

作者信息

Spelta Karla, Diniz Lucia M

机构信息

Federal University of Espírito Santo, Medical Graduate Program. Vitória, ES, Brazil.

Federal University of Rio de Janeiro, Medical Graduate Program. Rio de Janeiro, RJ, Brazil.

出版信息

Rev Inst Med Trop Sao Paulo. 2016 Jul 11;58:49. doi: 10.1590/S1678-9946201658049.

Abstract

BACKGROUND

Tuberculosis is a serious health problem in Brazil so that the knowledge on the aspects of cutaneous tuberculosis is medically important.

OBJECTIVE

To assess the characteristics of patients with cutaneous tuberculosis treated at the Cassiano Antonio Moraes University Hospital, located in the city of Vitória, State of Espírito Santo, Brazil.

METHODS

This is a retrospective, descriptive, observational and cross-sectional study using the medical records of 29 patients with cutaneous tuberculosis treated at the Dermatology and Pulmonology services of the hospital from 1986 to 2011. The inclusion criterion was the confirmation of cutaneous tuberculosis taking into account clinical, epidemiological, immunological, and bacteriological findings, as well as the response to specific treatment.

RESULTS

Of the 29 studied patients; 18 (62%) were women with average age of 37 years; the predominant clinical condition was erythema induratum of Bazin in 12 (41.4%) cases; and the cutaneous lesions were in the lower limbs in 19 (65.8%) patients. Extra-cutaneous involvement occurred in eight (27.6%) cases. The tuberculin tests were positive in 15 (79%) individuals and the assessment of the infectious agent was negative in most of the investigated cases.

CONCLUSION

The study found a low frequency (0.44%) of cutaneous tuberculosis in an endemic area of tuberculosis. There was a predominance of infection in women aged thirty to forty years. Erythema induratum was the most common clinical condition, affecting mainly the lower limbs, in contrast to other Brazilian studies that found scrofuloderma as the most common manifestation, predominating in the cervical region of male children and adolescents.

摘要

背景

结核病在巴西是一个严重的健康问题,因此了解皮肤结核的各个方面具有重要的医学意义。

目的

评估在巴西圣埃斯皮里图州维多利亚市卡西阿诺·安东尼奥·莫赖斯大学医院接受治疗的皮肤结核患者的特征。

方法

这是一项回顾性、描述性、观察性横断面研究,使用了1986年至2011年在该医院皮肤科和肺病科接受治疗的29例皮肤结核患者的病历。纳入标准是根据临床、流行病学、免疫学和细菌学检查结果以及对特定治疗的反应来确诊皮肤结核。

结果

在29例研究患者中,18例(62%)为女性,平均年龄37岁;主要临床情况为巴赞硬红斑,共12例(41.4%);19例(65.8%)患者的皮肤病变位于下肢。8例(27.6%)出现皮肤外受累。15例(79%)个体的结核菌素试验呈阳性,在大多数调查病例中,感染因子评估为阴性。

结论

该研究发现在结核病流行地区皮肤结核的发生率较低(0.44%)。30至40岁女性感染更为普遍。硬红斑是最常见的临床情况,主要影响下肢,这与其他巴西研究不同,其他研究发现瘰疬性皮肤结核是最常见的表现,主要发生在男童和青少年的颈部。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a98/4964318/08c48fb4e1f5/0036-4665-rimtsp-58-00049-gf1.jpg

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