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三级医疗中心寻常狼疮的临床病理研究

A Clinico-Histopathological Study of Lupus Vulgaris at a Tertiary Care Centre.

作者信息

Behera Binodini, Jain Sonal, Mohapatra Liza, Masatkar Vaishali, Panda Sibaram

机构信息

Department of Dermatology, Pandit Raghunath Murmu Medical College, Baripada, IND.

Department of Dermatosurgery and Hair Transplantation, CUTIS Hospital, Bengaluru, IND.

出版信息

Cureus. 2023 Jul 30;15(7):e42710. doi: 10.7759/cureus.42710. eCollection 2023 Jul.

Abstract

Background and objectives Lupus vulgaris is a chronic, progressive, paucibacillary form of cutaneous tuberculosis that occurs in persons with moderate to high immunity. Due to its varied clinical presentation, it can masquerade as different dermatological conditions. This study describes the demographic patterns and varieties of clinical manifestations that can be possible in this curable illness. Methods This study was conducted over two years and included 19 patients with histopathologically confirmed lupus vulgaris in Odisha, India. Demographic data, clinical features, and response to treatment are presented. Results Thirteen cases (68.4%) were seen in adults and six (31.6%) in pediatric patients. The lower limbs were the more affected (n=10), followed by the upper limb (6), the face (2), and the chest (1). All but one patient had plaque-type lesions. On histopathology, all showed a tuberculoid granuloma with no demonstration of acid-fast bacilli with Ziehl-Neelsen staining. Conclusion In the present study, the incidence was mostly observed in the young and higher activity age groups (5-40 years). Plaque-type lesions were most commonly encountered. In histopathology, all the cases had tubercular granuloma-type lesions without any incidence of malignant transformations. All the patients responded well to conventional multi-drug anti-tubercular chemotherapeutic regimens.

摘要

背景与目的 寻常狼疮是一种慢性、进行性、少菌型皮肤结核,发生于免疫力中等至高的人群。由于其临床表现多样,可伪装成不同的皮肤病。本研究描述了这种可治愈疾病可能出现的人口统计学模式和临床表现类型。方法 本研究历时两年,纳入了印度奥里萨邦19例经组织病理学确诊为寻常狼疮的患者。呈现了人口统计学数据、临床特征及治疗反应。结果 13例(68.4%)见于成人,6例(31.6%)见于儿童患者。下肢受累较多(n = 10),其次是上肢(6例)、面部(2例)和胸部(1例)。除1例患者外,所有患者均有斑块型病变。组织病理学检查显示,所有病例均为结核样肉芽肿,齐-尼染色未显示抗酸杆菌。结论 在本研究中,发病率大多见于年轻及高活动年龄组(5 - 40岁)。最常见的是斑块型病变。组织病理学检查中,所有病例均有结核性肉芽肿型病变,无恶变发生。所有患者对传统的多药抗结核化疗方案反应良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb7d/10420341/cc2121d13978/cureus-0015-00000042710-i01.jpg

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