误诊为痣的皮肤结核一例报道并文献复习

A case of cutaneous tuberculosis misdiagnosed as nevus and literature reviews

对2016年3月10日就诊于沈阳市胸科医院的一例皮肤结核患者的临床资料和实验室检查进行综合分析。患者为女性，53岁。左腿胭窝处可见一处苹果酱色，面积约7cm×8cm的色素沉着，呈斑块状，微隆起于皮肤表面，斑块表面高低不平；通过血结核抗体试验、结核感染T细胞酶联免疫斑点试验及血红细胞沉降率、胸部CT等检查初步诊断为皮肤结核，最终经组织病理学确诊为皮肤结核。给予口服抗结核药物（异烟肼、利福平、吡嗪酰胺、乙胺丁醇）抗结核治疗，同时局部给予利福平滴眼液治疗，治疗1个月后，患者左膪处病灶明显缩小，目前仍处于随访观察期间。作者分析了此例患者的诊治情况，并进行了文献复习，以提高对皮肤结核的认识，避免误诊。

C1inical data and laboratory tests ot a cutaneous tuberculosis patient who vlmted bhenyang Chest Hospital on March 10, 2016 were analyzed. A 7 cm× 8 em uneven plaque pigmentation with color of apple sauce slightly elevating on the skin surface was found in the left leg of this female patient at the age of 53 years old. The initial diagnosis of cutaneous tuberculosis was based on the blood tuberculosis antibody test, enzyme tuberculosis infected T cells linked immunosorbent spot test, erythrocyte sedimentation rate, chest CT and other tests, and then was confirmed by histopathological test. After 1-month treatment of oral administration of anti-tuberculosis drugs （isoniazid, rifampicin, pyrazinamide, ethambutol） and locally administration of rifampicin eye drops, the focus was Obviously shrinked, and the patient is still in the period of follow-up now. The diagnosis and treatment of this patient as well as literature review were analyzed in this report, in order to improve the understanding of cutaneous tuberculosis, to avoid misdiagnosis.