临床误诊误治Issue(2)：16-19,4.DOI:10.3969/j.issn.1002-3429.2016.02.004
溃疡性皮肤结核八例误诊分析
Misdiagnosis Analysis of 8 Cases of Ulcerative Cutaneous Tuberculosis
努尔保拉提·阿曼 1阿合提别克·塔布斯 1李剑辉 1李建刚 1周军 2阿不都斯木·艾沙 1马博 1陈赵慧3
作者信息
- 1. 830063 乌鲁木齐，新疆医科大学第二附属医院普通外科
- 2. 510235 广州，中山大学孙逸仙纪念医院胃肠外科
- 3. 830063 乌鲁木齐，新疆医科大学第二附属医院皮肤科
- 折叠
摘要
Abstract
Objective To discuss clinical characteristics, misdiagnosis factors and preventive measures of the ulcera-tive skin tuberculosis. Methods Clinical data of 8 misdiagnosed cases of cutaneous tuberculosis ulcerosa admitted into the Second Affiliated Hospital of Xinjiang Medical University during June 2005 and June 2014 were retrospectively analyzed. Re-sults Common characteristics of these 8 cases were that all the lesions occurred on the lower limb. It was manifested in the local skin from erythema, papules and nodules at the beginning of the disease, and then developed into ulcer, erosion, swell-ing and pain, with no symptoms of systemic tuberculosis poisoning. There were 4 cases of lower limb varicose ulcer, 2 cases of lower limb skin cancers and 2 cases of Bowen's disease were first treated and misdiagnosed by other hospitals. The misdiagno-sis duration was 5 to 36 months, with an average time of 20. 5 months. Upon admission to our hospital, 7 cases were diagnosed according to the medical history, clinical manifestation, the PPD test, Tuberculosis T lymphocytes spot test ( T-SPOT. TB) , ulcer lesions secretions mycobacterium tuberculosis acid-fast stain and pathological examination. However, 1 case was con-firmed after diagnostic anti-tuberculosis treatment, instead of the pathological diagnosis. Each case was provided with the standard anti-tuberculosis treatment for 11 months, local lesions were treated for 6 to 9 months, without skin-grafting. Fol-lowed up for 12 to 18 months, the patients had no recurrence. Conclusion The cutaneous tuberculosis ulcerous is rare with-out obvious clinical manifestations and tends to be misdiagnosed. In treatment of this disease with a long course or persistent uncured leg ulcers clinicians should consider cutaneous tuberculosis ulcerosa and make pathological examination. If necessary, diagnostic anti-tuberculosis treatment should be given for the benefit of early confimation.关键词
结核,皮肤/误诊/静脉曲张溃疡/皮肤肿瘤Key words
Tuberculosis, cutaneous/Misdiagnosis/Varicose ulcer/Skin neoplasm分类
医药卫生引用本文复制引用
努尔保拉提·阿曼,阿合提别克·塔布斯,李剑辉,李建刚,周军,阿不都斯木·艾沙,马博,陈赵慧..溃疡性皮肤结核八例误诊分析[J].临床误诊误治,2016,(2):16-19,4.
