Kaul Subuhi, Jakhar Deepak, Mehta Shilpa, Singal Archana
Department of Internal Medicine, John H Stroger Hospital of Cook County, Chicago, Illinois.
Dermosphere Clinic, New Delhi, India.
J Am Acad Dermatol. 2023 Dec;89(6):1107-1119. doi: 10.1016/j.jaad.2021.12.064. Epub 2022 Feb 8.
Despite the availability of effective treatment regimens for cutaneous tuberculosis, challenges to disease control result from delayed diagnosis, infection with multidrug-resistant mycobacterial strains, and coinfection with HIV. Delayed diagnosis can be mitigated when dermatologists are sensitized to the clinical signs and symptoms of infection and by the incorporation of appropriate diagnostic tests. All cases of cutaneous tuberculosis should be confirmed with histopathology and culture with or without molecular testing. In each case, a thorough evaluation for systemic involvement is necessary. Mycobacteria may not be isolated from cutaneous tuberculosis lesions and therefore, a trial of antituberculosis treatment may be required to confirm the diagnosis. The second article in this 2-part continuing medical education series describes the sequelae, histopathology, and treatment of tuberculosis.
尽管有针对皮肤结核的有效治疗方案，但疾病控制面临挑战，原因包括诊断延迟、感染耐多药分枝杆菌菌株以及合并感染艾滋病毒。当皮肤科医生对感染的临床体征和症状保持敏感，并采用适当的诊断检测时，诊断延迟的情况可以得到缓解。所有皮肤结核病例均应通过组织病理学和培养（无论是否进行分子检测）来确诊。在每种情况下，都有必要对全身受累情况进行全面评估。分枝杆菌可能无法从皮肤结核病变中分离出来，因此，可能需要进行抗结核治疗试验以确诊。这个两部分的继续医学教育系列中的第二篇文章描述了结核病的后遗症、组织病理学和治疗方法。
