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[从当前视角看结核疹概念]

[The tuberculid concept from the current viewpoint].

作者信息

Braun-Falco O, Thomas P

机构信息

Dermatologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, München.

出版信息

Hautarzt. 1995 Jun;46(6):383-7. doi: 10.1007/s001050050270.

Abstract

The concept of tuberculid was introduced by Darier in 1896. In contrast to "true" cutaneous tuberculosis, properties of the tuberculids were explained by an hyperergic response to myobacteria or their fragments released from a different site of manifest or passed tuberculous infection. Key features include a strongly positive tuberculin skin test, evidence of concomitant manifest or past tuberculosis, and prompt response to antituberculous therapy. The inability to culture M. tuberculosis or to demonstrate it microscopically from lesional biopsies, together with reports on tuberculid-like eruptions after BCG vaccination, supports this concept. Clinical manifestations are lichen scrophulosorum, papulo-necrotic tuberculids and erythema induratum of Bazin. The existence of tuberculids has been questioned, however, because the clinical and histological appearances are not always specific. An increasing number of case reports on tuberculids, new immunological tests and molecular biology-based techniques for the detection of mycobacteria have shed new light on the tuberculid concept.

摘要

结核疹的概念由达里埃于1896年提出。与“真正的”皮肤结核不同,结核疹的特性被解释为对分枝杆菌或其从明显或既往结核感染的不同部位释放的片段的超敏反应。关键特征包括结核菌素皮肤试验强阳性、伴有明显或既往结核病的证据以及对抗结核治疗的迅速反应。无法从病变活检组织中培养出结核分枝杆菌或在显微镜下证实其存在,以及关于卡介苗接种后出现结核疹样皮疹的报告支持了这一概念。临床表现为瘰疬性苔藓、丘疹坏死性结核疹和巴赞硬红斑。然而,结核疹的存在受到了质疑,因为其临床和组织学表现并不总是具有特异性。越来越多关于结核疹的病例报告、新的免疫学检测方法以及基于分子生物学的分枝杆菌检测技术为结核疹的概念带来了新的认识。

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