Iborra C, Cambau E, Lecomte C, Grosset J, Bricaire F, Caumes E
Service des Maladies Infectieuses et Tropicales, Groupe Hospitalier Pitié-Salpêtrière, Paris.
Ann Dermatol Venereol. 1997;124(2):139-43.
The recent increase in the incidence of tuberculosis has led to the return of cutaneous forms of this disease. In addition, diagnosis can now be made rapidly using genoma amplification.
Four cases of cutaneous tuberculosis are described in nonimmunosuppressed patients: two cases of lupus vulgaris, including one due to Mycobacterium africanum, and two others of gummas, including one associated with tuberculosis verrucosa. The diagnosis was suggested by epidemiological, clinical, histological and immunological findings and confirmed by culture of the bacilli in 3 cases and by genoma amplification in 1.
These observations illustrate the difficulties encountered in determining the tuberculosis nature of skin lesions. The clinical presentation, differential diagnosis, the pathophysiology of this disease and the new interest in genoma amplification are discussed.
近期结核病发病率的上升导致了这种疾病皮肤形式的再度出现。此外，现在可以通过基因组扩增快速做出诊断。
描述了4例非免疫抑制患者的皮肤结核病例：2例寻常狼疮，其中1例由非洲分枝杆菌引起，另外2例为梅毒瘤，其中1例与疣状结核相关。诊断通过流行病学、临床、组织学和免疫学检查结果提示，3例通过杆菌培养确诊，1例通过基因组扩增确诊。
这些观察结果说明了在确定皮肤病变的结核性质时所遇到的困难。讨论了临床表现、鉴别诊断、该疾病的病理生理学以及对基因组扩增的新关注。
