Wu Shaofang, Wang Wu, Chen Huan, Xiong Wen, Song Xin, Yu Xinmin
Department of Pathology Department of Anesthesiology, Lishui Central Hospital, Lishui, Zhejiang, China.
Medicine (Baltimore). 2018 Jun;97(22):e10836. doi: 10.1097/MD.0000000000010836.
Ulcerative skin tuberculosis (TB) is a rare form of extrapulmonary TB.
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.
Anti-TB therapy with isoniazid, rifampicin, ethambutol, and pyrazinamide for 6 months. The skin ulcer completely healed after 6 months.
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.
溃疡性皮肤结核是肺外结核的一种罕见形式。
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。
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。
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。