Department of Dermatology, Stanford University Medical Center, Stanford, California, USA.
Department of Pathology, Stanford University Medical Center, Stanford, California, USA.
J Cutan Pathol. 2020 Aug;47(8):725-728. doi: 10.1111/cup.13678. Epub 2020 Mar 19.
Cutaneous tuberculosis is an uncommon entity with several clinical forms recognized. Histopathologically, most cases are characterized by granulomatous inflammation and caseating necrosis, although less common findings, including vasculitis, have also been described. We report a 55-year-old male with a history of recently diagnosed dermatomyositis receiving immunosuppression with mycophenolate mofetil and prednisone, who developed multifocal soft tissue abscesses and an indurated erythematous plaque on the back. Skin biopsy of the back revealed a necrotizing medium-vessel vasculitis. Mycobacterium tuberculosis was detected in the skin via acid-fast bacilli stain and confirmed by tissue culture and polymerase chain reaction. Cutaneous findings improved rapidly with antituberculosis therapy. This case illustrates an uncommon clinical and histopathologic presentation of disseminated tuberculosis.
皮肤结核是一种少见的疾病，有多种临床形式。组织病理学上，大多数病例的特征是肉芽肿性炎症和干酪样坏死，尽管也有描述较少见的发现，包括血管炎。我们报告了一例 55 岁男性，患有最近诊断的皮肌炎，接受霉酚酸酯和泼尼松的免疫抑制治疗，他背部出现多发性软组织脓肿和硬结性红斑。背部皮肤活检显示坏死性中等血管血管炎。皮肤分枝杆菌通过抗酸杆菌染色检测到，组织培养和聚合酶链反应证实。抗结核治疗后皮肤病变迅速改善。该病例说明了播散性结核的一种少见的临床和组织病理学表现。
