Boudghene-Stambouli O, Merad-Boudia A, Bouali O, Ould-Amrouche N, Tchouar S
Service de Dermato-Vénéréologie, Centre Hospitalo-Universitaire de Tlemcen, Algérie.
Bull Soc Pathol Exot Filiales. 1989;82(3):341-50.
The cutaneous tuberculosis (CTB) is still frequent in Algeria. From March 81 through December 87, forty-five cases were observed in our service of Dermato-Venereology (CHU Tlemcen), something like 6.4 cases per year. The two sexes are equally represented; 66.6% aged under 40; 66.6% are living in cities and have modest social and economical conditions; 20% were inoculated with BCG; previous CTB (personal 8.8% of family 11.1%) were hardly seen. It took some 44% of the patients less than a year to ask for a diagnosis, after receiving several non specific treatments. The rest took longer to come for consultation and in one case, the disease evaluated for 28 years. One explanation is that sometimes the affection causes very little annoyance. The clinical aspects observed were often evocative: Lupus vulgaris, 28.8%, scrofuloderma, 28.8%, specific adenitis, 13.3%, tuberculosis verrucosa cutis, 13.3%, gum, 13.9%, ulcerous CTB, 2.2%. Tuberculin skin test was positive for 86% of the cases and was taken into consideration when it reaches over 15 mm (46%), and with discomfort (4.4%). The treatment was efficient in the large majority of the cases. However, 29.5% of the patients gave up before the end of the cure. We insist upon the priority of the relationship doctor-patient in the case of a chronicle affection, which is less uneasy for some and shameful for a great many.
皮肤结核在阿尔及利亚仍很常见。从1981年3月至1987年12月,我们皮肤科性病科(特莱姆森大学医院)共观察到45例病例,每年约6.4例。男女比例相当;66.6%的患者年龄在40岁以下;66.6%生活在城市,社会经济条件一般;20%接种过卡介苗;既往有皮肤结核(个人8.8%,家族11.1%)的情况很少见。约44%的患者在接受几次非特异性治疗后不到一年就前来诊断。其余患者就诊时间较长,有一例病情长达28年。一种解释是,有时这种疾病引起的不适很少。观察到的临床症状往往具有提示性:寻常狼疮占28.8%,皮肤瘰疬占28.8%,特异性腺炎占13.3%,疣状皮肤结核占13.3%,丘疹坏死性结核疹占13.9%,溃疡性皮肤结核占2.2%。结核菌素皮肤试验86%的病例呈阳性,当硬结直径超过15毫米(46%)且伴有不适感(4.4%)时,该试验结果被纳入考虑。大多数病例的治疗是有效的。然而,29.5%的患者在疗程结束前放弃治疗。对于慢性病,我们强调医患关系的重要性,因为有些患者对此不太在意,而很多患者则感到羞愧。