Analysis of Clinicopathological Characteristics and Treatment of 23 Patients with Cutaneous Tuberculosis
Objective To investigate the clinicopathological characteristics and treatment of cutaneous tuberculosis(CTB),and to provide a basis for the clinical diagnosis and treatment of CTB.Methods Clinical data of 23 patients with CTB treated in our hospital during March 2022 to September 2023 were included to analyze the epidemiology,clinicopathological characteristics,efficacy of anti-tuberculosis treatment,adverse reactions and follow-up after treatment.Results In this study,erythema induratum and papular necrotic tuberculid were more common in 23 patients.12 patients(52.17％)had a history of close contact with tuberculosis,and systemic tuberculosis.CTB had various clinical manifestations and was prone to misdiagnosis and delayed diagnosis,among which papular necrotic tuberculid was the most likely to be misdiagnosed(100.00％).All tuberculin skin test(100.00％)were positive,Interferon-gamma release assay were positive in 22 patients(95.65％),and 19 patients(82.61％)had imaging changes on lung CT.The histopathology of the skin was mainly characterized by granuloma formation and multinucleated giant cells and mixed inflammatory cell infiltration.There were neutrophil abscess,necrosis,eosinophils and vasculitis.Finally,6 patients with pulmonary tuberculosis and 3 patients with old pulmonary tuberculosis were detected.The 2HREZ+4HR and 12HRE regimen had a high recovery rate,but inadequate treatment might lead to recurrence of rash and pulmonary tuberculosis.The main adverse drug reactions were liver disfunction,rash,increased uric acid and leukopenia.Conclusion The diagnosis of CTB requires a comprehensive medical history,especially tuberculosis history or exposure history,skin lesions,histopathological examination,etiological testing and immunological index(including acid-fast staining,tuberculin test,interferon γ release test and polymerase chain reaction of mycrobacterium tuberculosis).Early recognition and diagnosis of CTB plays an important role in the prevention and treatment of tuberculosis,sufficient and full-course anti-tuberculosis treatment is effective and adverse reactions need to be monitored.
万方数据
维普
