12例寻常狼疮临床分析

Clinical analysis of lupus vulgaris： 12 case reports

目的探讨12例寻常狼疮患者临床特点及治疗。方法对12例确诊为寻常狼疮患者的临床特点、组织病理、误诊原因、治疗及转归情况等进行分析。结果12例中83．3％发病前有局部外伤史。所有患者发病早，病程长，多数无明显自觉症状，皮损形态多样，首诊均被误诊，经组织病理、结核菌素纯蛋白衍化物试验、抗酸染色、结核杆菌培养、DNA测序等检查明确诊断。经规范抗结核治疗后预后均良好。结论临床医生应加强对寻常狼疮的认识，通过组织病理、培养等检查可确诊。

Objective To study the clinical features and treatment of 12 cases of lupus vulgaris. Methods A comprehensive study was performed on 12 patients with lupus vulgaris. The clinical and histopathological features, misdiagnosis, treatment and prognosis of this entity were analyzed. Results Of these patients, 83.3% had a history of local trauma before the occurrence of lupus vulgaris. All the patients showed an early onset and long clinical course of lupus vulgaris, absence of obvious symptoms and variety in skin lesions. Lupus vulgaris was misdiagnosed at the first visit in all the patients. The final diagnosis was confirmed by histopathology, purified protein derivative （PPD） test, acid-fast staining, Mycobactedum tuberculosis culture, DNA sequencing, etc. Satisfactory outcomes were achieved in these patients after standard anti-tuberculosis treatment. Conclusions Lupus vulgaris is easy to be misdiagnosed and improperly treated due to its complicated clinical features. Clinicians should expand their knowledge about this entity, which can be diagnosed by histopathology and culture.