皮肤结核3例  

Three cases of cutaneous tuberculosis

作　　者：王利群 张文涛 孙珂岱 岑蕊言 岳陈达 邓雨萌 雷霞 WANG Liqun;ZHANG Wentao;SUN Kedai;CEN Ruiyan;YUE Chenda;DENG Yumeng;LEI Xia(Department of Dermatology,Daping Hospital,Army Specialty Medical Center,Chongqing 400042,China)

机构地区：[1]陆军军医大学陆军特色医学中心皮肤科,重庆400042

出　　处：《临床皮肤科杂志》2025年第3期149-153,共5页Journal of Clinical Dermatology

摘　　要：报告3例皮肤结核。例1男,47岁。左侧肩颈部皮下结节、红肿伴疼痛3个月。皮肤科检查:左侧肩颈部3个大小不等结节,呈串珠样排列。例2男,67岁。左手示指红肿及溃疡半年,加重15 d。皮肤科检查:左手示指红肿,其上溃疡,基底部脓性分泌物及痂壳覆着。例3女,44岁。双下肢红斑及结节伴疼痛4年,加重1周。皮肤科检查:双下肢散在类圆形暗红斑,沿淋巴管分布。3例患者结核感染T细胞斑点试验(T-SPOT)均为阳性,其中两例行组织病理检查,提示有干酪样坏死及上皮样肉芽肿形成,两例胸部CT检查提示有结核样或炎性改变。诊断:皮肤结核。予抗结核药2个月强化及4个月维持治疗,预后均良好。Three cases of cutaneous tuberculosis are reported. Case 1. A 47-year-old male presented with subcutaneous nodules, redness, swelling, and pain in the left shoulder and neck for three months. Dermatologic examination revealed three nodules of varying sizes in the left shoulder and neck, arranged in a bead-like pattern. Case 2. A 67-year-old male presented with erythema and ulceration of the left digit for six months, which had worsened over the previous 15 days. Dermatologic examination revealed erythema, ulceration, purulent discharge, and crusting at the base of the left digit. Case 3. A 44-year-old female presented with erythema and painful nodules on both lower limbs for four years, which had aggravated over the previous week.Dermatologic examination revealed scattered, roundish, dark erythema along the lymphatic vessels on both lower limbs. In the three cases, T-SPOT testing was positive. Two patients underwent histopathological examination, which showed caseous necrosis and epithelioid granuloma formation. Thoracic CT examination revealed tuberculous or inflammatory changes in two cases. Mycobacteria DNA testing, strain identification, and gene chip analysis were all positive, confirming the diagnosis of cutaneous tuberculosis. After diagnosis, all patients were treated with two months of intensive anti-tuberculosis therapy, followed by four months of maintenance treatment. Good outcomes were achieved in all the three cases.

关 键 词：皮肤结核 诊断 结核治疗 

分 类 号：R592.4[医药卫生—老年医学]