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肛周溃疡性皮肤结核:一例报告。

Perianal ulcerative skin tuberculosis: A case report.

作者信息

Wu Shaofang, Wang Wu, Chen Huan, Xiong Wen, Song Xin, Yu Xinmin

机构信息

Department of Pathology Department of Anesthesiology, Lishui Central Hospital, Lishui, Zhejiang, China.

出版信息

Medicine (Baltimore). 2018 Jun;97(22):e10836. doi: 10.1097/MD.0000000000010836.

Abstract

RATIONALE

Ulcerative skin tuberculosis (TB) is a rare form of extrapulmonary TB.

CASE REPORT

We present a case of a 65-year-old patient with perianal ulcer, which had been present for 1 year. Anamnesis revealed he had been persistently coughing for the same period of time. Histological examination of perianal skin showed necrotizing granulomatous lesions, acid-fast staining in sputum samples was ++++, TB antibody in the blood was positive, TB DNA test was positive, and chest scan that showed secondary pulmonary TB accompanied by possible pulmonary cavity formation in the 2 upper lungs.

INTERVENTIONS

Anti-TB therapy with isoniazid, rifampicin, ethambutol, and pyrazinamide for 6 months. The skin ulcer completely healed after 6 months.

CONCLUSION

TB should be suspected for nonhealing ulcers. Pertinent studies should be done early during the lesion; finally, TB treatment should be initiated immediately after diagnosis is made.

摘要

原理

溃疡性皮肤结核是肺外结核的一种罕见形式。

病例报告

我们报告一例65岁患者,肛周溃疡已存在1年。既往史显示他在同一时期持续咳嗽。肛周皮肤组织学检查显示坏死性肉芽肿病变,痰涂片抗酸染色++++,血液中结核抗体阳性,结核DNA检测阳性,胸部扫描显示继发性肺结核,两上肺可能形成肺空洞。

干预措施

使用异烟肼、利福平、乙胺丁醇和吡嗪酰胺进行6个月的抗结核治疗。6个月后皮肤溃疡完全愈合。

结论

对于不愈合的溃疡应怀疑结核。在病变早期应进行相关检查;最后,确诊后应立即开始抗结核治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4881/6392906/76e29deff0ac/medi-97-e10836-g001.jpg

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