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題名 | 皮膚開口處結核=Tuberculosis Cutis Orificialis |
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作者 | 羅珮瑜; 許乃仁; 宗天一; 陳自強; Lo, Pei-yu; Hsu, Nai-jen; Tzung, Tien-yu; Chen, Tsu-chyang; |
期刊 | 中華皮膚科醫學雜誌 |
出版日期 | 20000300 |
卷期 | 18:1 2000.03[民89.03] |
頁次 | 頁74-79 |
分類號 | 415.721 |
語文 | chi |
關鍵詞 | 皮膚開口處結核; Tuberculosis cutis orificialis; Polymerase chain reaction; Mycobacterium tuberculosis; |
中文摘要 | 皮膚開口處結核是一種罕見的皮膚結核,位於鄰近體表開口處的黏膜或皮膚,藉由進行性體內結核菌再接種而出現結核菌感染。本文報告一位71歲的男性病人,主訴其右臀近肛門處出現數個發炎性結節有一年之久,此病灶迅進惡化而形成疼痛性潰瘍,皮膚組織病理切片顯示在真皮處為肉芽腫性發炎反應,並可見乾酪性壞死及散在蘭漢氏巨細胞,抗酸性染色發現許多抗酸性桿菌,胸部X光檢查可見右上肺葉纖維鈣化浸潤,兩側肺葉也有肋膜增厚的情形,取皮膚病灶組織做聚合酶鍊反應,呈現陽性結果;之後送檢痰液及皮膚皆培養出結核菌,因此診斷為皮膚開口處結核,並且投與抗結核藥物治療。六週左右皮膚潰瘍、紅腫病灶已明顯好轉,病人服藥六個月後胸部X光檢查也回復正常了。 |
英文摘要 | Tuberculosis cutis orificialis (TCO) is a rare manifestation of cutaneous tuberculosis that occurs in mucous membranes and skin adjacent to natural orifices due to autoinoculation of bacilli from advanced visceral tuberculosis. We report a 71-year-old male who suffered from inflammatory nodules over right side of the gluteal region for one year. The skin eruptions soon became scattered or confluent perianal ulcers. Histopathology of a biopsy specimen showed several granulomas with caseous necrosis, Langhans’ giant cells and numerous acid-fast bacilli by acid-fast stain. The chest X-ray revealed fibrocalcified infiltration over right upper lobe with bilateral pleural thickening. Polymerase chain reaction (PCR) from skin lesions indicated positive result of Mycobacterium tuberculosis complex. Culture of biopsied skin and sputum yielded colonies of M. tuberculosis complex. TCO was diagnosed and the patient was treated with anti-TB drugs. The skin lesions resolved within 6 weeks and chest X-ray returned normal after 6 months treatment. |
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