长期误诊的疣状皮肤结核1例

A Case of Long-term Misdiagnosis of Tuberculosis Verrucosa Cutis

患者男,43岁。肛周丘疹、斑块19年余,无明显自觉症状。曾被误诊为"深部真菌病"、"蕈样肉芽肿"、"皮肤软化斑"。皮损组织病理示:表皮角化过度伴角化不全,表皮假瘤样增生;真皮可见由淋巴细胞、浆细胞、中性粒细胞、组织细胞和少量多核巨细胞组成的肉芽肿;PAS染色(-),抗酸染色(-)。PPD皮试(3+);PPD-IgG(+)。诊断为疣状皮肤结核。经抗结核治疗半年后皮损基本消退。

A 43-year-old male had asymptomatic perianal papules and plaques for over 19 years. He had been misdiagnosed as “deep mycosis”,”mycosis fungoides” and ”malacoplakia”.The histopathologic features included epidermal hyperkeratosis and parakeratosis, pseudo- epitheliomatous hyperplasia. Dermal granulomas were composed of lymphocytes, plasmocytes, neutrophils, histocytes, and few multinucleated giant cells. Tumor tissue was negative for both PAS and Acid-fast staining. But patient was positive for PPD test（3＋）and PPD-IgG （＋）.Diagnosis：tuberculosis verrucosa cutis.The lesions improved after 6 months of treatment.