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寻常性狼疮:一篇叙述性综述。

Lupus vulgaris: a narrative review.

机构信息

Department of Dermatology and STD, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India.

Department of Dermatology and STD, National Institute of Medical Sciences and Research, Jaipur, India.

出版信息

Int J Dermatol. 2024 Apr;63(4):431-437. doi: 10.1111/ijd.16987. Epub 2023 Dec 15.

Abstract

Lupus vulgaris (LV) is a type of paucibacillary cutaneous tuberculosis that can occur due to inoculation, lymphatic, or hematogenous route. It occurs in a previously sensitized individual with high immunity to tuberculosis. LV can have different morphology of presentation, which can lead to difficulty in diagnosis. The Tuberculin test is strongly positive. Histopathology will show epithelioid granulomas in the superficial dermis and acid-fast bacilli rarely demonstrable within the granulomas. Dermoscopy will show focused linear vessels on a yellow to orange background. Culture is the gold standard for diagnosis, but its positivity rate is low. Mycobacterium tuberculosis bacilli can be detected using polymerase chain reaction from the lesions. Histopathology, tuberculin test, dermoscopy, molecular test, and culture would help diagnose LV. This review discusses the introduction, pathogenesis, clinical features, differential diagnosis, investigations, complications, and treatment of lupus vulgaris in detail. This review can help the dermatologist understand the condition better with appropriate diagnosis and therapy.

摘要

寻常狼疮(LV)是一种少菌型皮肤结核,可通过接种、淋巴或血源途径发生。它发生在对结核病具有高度免疫力的既往致敏个体中。LV 可能具有不同的表现形态,这可能导致诊断困难。结核菌素试验呈强阳性。组织病理学将显示浅真皮中的上皮样肉芽肿,很少在肉芽肿内显示抗酸杆菌。皮肤镜检查将显示黄色至橙色背景上的聚焦线性血管。培养是诊断的金标准,但阳性率较低。聚合酶链反应可从病变中检测到结核分枝杆菌。组织病理学、结核菌素试验、皮肤镜检查、分子试验和培养有助于诊断 LV。这篇综述详细讨论了寻常狼疮的发病机制、临床特征、鉴别诊断、检查、并发症和治疗。这篇综述可以帮助皮肤科医生更好地了解病情,进行适当的诊断和治疗。

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