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播散性结核表现为皮肤白细胞碎裂性血管炎。

Disseminated tuberculosis presenting as cutaneous leucocytoclastic vasculitis.

机构信息

Medicine, Maulana Azad Medical College, New Delhi, Delhi, India.

Medicine, Maulana Azad Medical College, New Delhi, Delhi, India

出版信息

BMJ Case Rep. 2023 May 18;16(5):e254661. doi: 10.1136/bcr-2023-254661.

Abstract

Cutaneous leucocytoclastic vasculitis (CLV) is a type of small vessel vasculitis, predominantly presenting with palpable purpuras and sometimes with systemic manifestations. The following report describes the case of a woman, who presented with fever, anorexia and maculopapular lesions over both lower limbs. Skin biopsy revealed CLV. CT scan demonstrated bilateral pulmonary nodules, ileocecal wall thickening and generalised lymphadenopathy. Colonoscopy guided biopsy obtained from ileocecal valve ulcer showed epitheloid cell granuloma with Langhans-type giant cells and caseous necrosis. Rapid clinical improvement was seen with anti-tubercular therapy. Among infectious causes, although rare and an uncommon presentation, should be considered as an important cause of CLV.

摘要

皮肤白细胞碎裂性血管炎(CLV)是一种小血管血管炎,主要表现为可触及性紫癜,有时伴有全身表现。以下报告描述了一名女性患者,其表现为发热、食欲不振和双下肢多发性斑丘疹。皮肤活检显示为 CLV。CT 扫描显示双侧肺结节、回盲部肠壁增厚和全身淋巴结病。回盲瓣溃疡的结肠镜引导活检显示类上皮细胞肉芽肿,伴郎汉斯型巨细胞和干酪样坏死。抗结核治疗后临床迅速改善。在感染性病因中,虽然罕见且表现不常见,但 也应被视为 CLV 的重要病因。

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