溃疡性皮肤结核3例临床分析

Three cases report of tuberculosis ulcerosa

目的提高对溃疡性皮肤结核的认识和诊断能力。方法对3例溃疡性皮肤结核患者的临床资料进行回顾性分析。结果3例患者中,男2例,女1例,年龄分别为30、32、55岁,均在外阴或肛周处大小不等的溃疡、糜烂、疼痛。1例无内脏结核,皮损组织结核杆菌培养(-),但聚合酶链反应(PCR)(+);2例分别有肺结核和右肾结核者,其皮损组织结核杆菌培养(+),PCR(+)。3例抗结核治疗2、3个月,溃疡均愈合,随访半年无复发。结论溃疡性皮肤结核少见。对于临床上顽固的皮肤溃疡应考虑到结核杆菌感染的可能性,皮损组织PCR检查较皮肤病理、抗酸染色及结核杆菌培养更具有临床诊断意义。

Objective To improve the diagnosis level on tuberculosis ulcerosa. Methods The clinical data of three patients with tuberculosis ulcerosa was analyzed retrospectively. Results Of three patients, two were male and one was female. The patients age was thirty, thirty- two, and fifty-five, respectively. All three patients presented symptoms with ulcer around vulva or anus companied by erosion and pain. One patient was not with viscera tuberculosis, whose results of mycobacterium tuberculosis culture was negative, but polymerase chain reaction (PCR) was positive. The other two suffered from lung or right kidney tuberculosis respectively, whose results of mycobacterium tuberculosis culture and PCR were positive. Three patients cured after antituberculotic treatment with two￣three months. During the period of following-up with half an year, the lesions did not relapse. Conclusion Tuberculosis ulcerosa is a kind of rare disease. The intractable ulcer of skin is potentially brought by infection of mycobacterium tuberculosis. PCR is of more value in diagnosis of tuberculosis ulcerosa than histopathologic examination, antiacid staining, or mycobacterium tuberculosis culture.