Dermatology Department, Narendra Modi Medical College, LG Hospital, Maninagar, Ahmedabad 380008, Gujarat, India.
Indian J Tuberc. 2024 Oct;71(4):465-470. doi: 10.1016/j.ijtb.2024.01.002. Epub 2024 Jan 18.
Cutaneous Tuberculosis constitutes 1-1.5 % of extrapulmonary tuberculosis with a wide clinical spectrum which relies upon the portal of entry of mycobacteria and patient's immunity. Complications of cutaneous tuberculosis if treatment is delayed includes hazardous sequel like dissemination and disfigurement. Early diagnosis and cure is the ultimate way to prevent such complications. This has motivated us to study clinicoepidemiological, histopathological profile and outcome post treatment of cutaneous tuberculosis patients of our region in detail.
Total 78 patients were studied during the period of August 2018-2022, who were suspicious to have cutaneous tuberculosis clinically of which 54 were confirmed with histopathology. Patient related clinicoepidemiological data such as age, gender, past history of tuberculosis or contact history, chest-x ray, tuberculin test positivity was analysed in a retrospective manner.
Among the 54 biopsy proven cases (33 women, 21 men) ranging from 6 to 76 years, 27 patients have been found to have Lupus Vulgaris followed by 15 cases of scrofuloderma. Acid fast bacilli were seen in 9 patients with majority in scrofuloderma. Histopathology revealed epithelioid cell granuloma without necrosis in 34 cases and caseation necrosis in 20 patients. 48 patients showed complete recovery with 6 months of Anti-Koch Treatment and some complications were observed in remaining. Limitation of this research was that long term follow up was not possible.
Lack of familiarity might lead to overlooking of a standard presentation or misdiagnosis. So, an eagle eye with high degree of suspicion is crucial for control and prevention of morbidity and for improving socio-economic burden of cutaneous tuberculosis.
皮肤结核占肺外结核的 1-1.5%,临床表现广泛,取决于分枝杆菌的入侵途径和患者的免疫状态。如果治疗延迟,皮肤结核的并发症包括传播和毁容等危险后遗症。早期诊断和治疗是预防这些并发症的最终方法。这促使我们详细研究我们地区皮肤结核患者的临床流行病学、组织病理学特征和治疗后结果。
在 2018 年 8 月至 2022 年期间,共研究了 78 例疑似患有皮肤结核的患者,其中 54 例经组织病理学证实。采用回顾性方法分析了与患者相关的临床流行病学数据,如年龄、性别、既往结核病病史或接触史、胸部 X 光、结核菌素试验阳性。
在 54 例经活检证实的病例(33 名女性,21 名男性)中,年龄从 6 岁到 76 岁不等,27 例为寻常狼疮,其次是 15 例瘰疬。9 例患者可见抗酸杆菌,其中多数为瘰疬。组织病理学显示 34 例为上皮样细胞肉芽肿,无坏死,20 例为干酪样坏死。48 例患者在接受抗结核治疗 6 个月后完全康复,其余患者出现了一些并发症。本研究的局限性在于无法进行长期随访。
缺乏熟悉度可能导致对标准表现的忽视或误诊。因此,高度怀疑和敏锐的眼光对于控制和预防发病率以及减轻皮肤结核的社会经济负担至关重要。