Lim Jo Anne, Tan Wooi Chiang, Khor Boon Tat, Hukam Gopal Chand Sunita Devi, Palanivelu Tharmalingam
Department of Medicine, Hospital Sultan Abdul Halim, 08000 Sungai Petani, Kedah, Malaysia.
Department of Dermatology, Hospital Pulau Pinang, 10990 Georgetown, Penang, Malaysia.
J Am Coll Clin Wound Spec. 2018 Jun 21;9(1-3):35-38. doi: 10.1016/j.jccw.2018.06.003. eCollection 2017.
A 72-year-old man presented with a chronic scaly verrucous plaque over his right knee for nine months. The lesion was preceded by a well healed scar sustained five years back from a road traffic accident. He was given multiple courses of systemic antibiotic and antifungal medications but to no avail. A skin biopsy confirmed cutaneous tuberculosis. The area of plaque subsided significantly with antituberculosis treatment. However, during the second month of treatment, a new onset of a red fleshy granulating growth developed on the pre-existing site. A repeat skin biopsy revealed squamous cell carcinoma (SCC). He was subsequently referred for surgical excision. This is presumably the first reported case of SCC arising from tuberculosis verrucosa cutis. While most malignant transformations from tuberculosis has been thought to develop after a long period of time (usually more than twenty-five years), this case report showed that it may also occur within a short period of time. Awareness on this condition is important because any delay in diagnosis and treatment may have detrimental consequences.
一名72岁男性，右膝部出现慢性鳞屑性疣状斑块9个月。该病变之前有一个5年前因道路交通事故形成的愈合良好的瘢痕。他接受了多疗程的全身性抗生素和抗真菌药物治疗，但均无效。皮肤活检确诊为皮肤结核。经抗结核治疗后，斑块面积明显消退。然而，在治疗的第二个月，原部位出现了新的红色肉质颗粒状增生。再次皮肤活检显示为鳞状细胞癌（SCC）。随后他被转诊接受手术切除。这可能是首例报道的由疣状皮肤结核引发的鳞状细胞癌病例。虽然大多数由结核恶变被认为是在很长一段时间（通常超过25年）后发生，但本病例报告表明它也可能在短时间内出现。认识到这种情况很重要，因为任何诊断和治疗的延迟都可能产生有害后果。
