ulcerative skin tuberculosis
Introduction
Introduction to ulcerative skin tuberculosis Ulcerative skin tuberculosis (tuberculosiscutisverrucosa), also known as tuberculosis ulcer; tuberculosis cutisorificialis, more active tuberculosis in the internal organs, and active tuberculosis or laryngeal tuberculosis The patient, Mycobacterium tuberculosis can cause oral mucosal ulcers. If the bacteria-containing cockroaches are swallowed or intestinal tuberculosis, the tubercle bacilli in the stool can cause ulcers around the anus. In tuberculosis of the kidney or bladder, Mycobacterium tuberculosis can be inoculated into the urethra or genital area with urine, and tubercle bacilli can be found. It needs to be differentiated from three-stage syphilis ulcer, acute female vaginal ulcer and basal cell carcinoma. Treatment with primary skin tuberculosis syndrome. basic knowledge Sickness ratio: 0.0001% Susceptible population: people with tuberculosis Mode of infection: respiratory transmission Complications: cervical lymph node tuberculosis
Cause
Ulcerative skin tuberculosis
Bacterial infection (53%):
The viscera has active tuberculosis lesions, and the patient's resistance to Mycobacterium tuberculosis is weak. When the body excretion contains tubercle bacilli, it can be inoculated into the mucosa of the mouth to form an ulcer.
Disease factors (45%):
Active tuberculosis or laryngeal tuberculosis patients, tubercle bacilli can cause oral mucosal ulcers, such as bacteria containing phlegm swallowed or intestinal tuberculosis, tuberculosis in the stool can cause ulcers around the anus, kidney or bladder tuberculosis, Mycobacterium tuberculosis can be inoculated with urine in the urethra or genital area.
Prevention
Ulcerative skin tuberculosis prevention
Precautionary principle: It is mainly to mobilize the masses, vigorously publicize the prevention and treatment knowledge of tuberculosis, conduct regular health checkups, early diagnosis, early treatment, eliminate infection sources, eliminate infection routes, carry out BCG vaccination, and enhance the body's resistance.
Complication
Ulcerative skin tuberculosis complications Complications, cervical lymph node tuberculosis
Patients often have active visceral tuberculosis.
Symptom
Ulcerative skin tuberculosis symptoms Common symptoms Nodules, ulcers, abscesses, scars after ulceration
In the early stage, it is a pale yellow rice nodule or a small abscess. After the ulceration, it forms a shallow irregular shape ulcer. The bottom of the ulcer is uneven. It is a miliary nodule (Trelat small particle) or a purulent miliary abscess. The edge is not well-cut. There are yellow-gray cheese pussy, granulation is loose, easy to bleed, consciously pain, occurs in the natural opening of the skin, more common in the mouth, anus or genital area, can be extended to the junction of the skin mucosa, patients often have activity Visceral tuberculosis, tuberculosis is easy to detect in secretions, animal vaccination and culture is easy, tuberculin test is negative.
Examine
Examination of ulcerative skin tuberculosis
Tubercle bacilli are easily detected in the secretions, and animal inoculation and culture are easy to be successful, and the tuberculin test is negative.
Histopathological examination: There may be tuberculous infiltration in the deep or subcutaneous tissue of the dermis, and there is obvious caseous necrosis. Tubercle bacilli can be found, ulcers can form on the upper part of the epidermis and dermis, and the epidermis on the edge of the ulcer is hypertrophic.
Diagnosis
Diagnosis and diagnosis of ulcerative skin tuberculosis
According to clinical manifestations, histopathological examination, patients often have active visceral tuberculosis lesions, tuberculin test is negative, can be diagnosed.
Differential diagnosis
1. Stage III syphilis ulcer
The edges are neat, with dike-like bulges and dark red infiltration, mostly kidney-shaped, with a harder nature, and the syphilis serum reaction is often positive.
2. Acute female genital ulcer
After acute, the inflammation is relatively good, but it can be self-healing but easy to relapse. The ulcer is funnel-shaped, often with nodular erythema and canal stomatitis. The crude bacillus can be found in the secretion.
Basal cell carcinoma
There are many pearl-like nodules on the base of the ulcer, the edges are rolled up, and the touch is hard. The biopsy has a typical histopathological image.
