papular necrotizing tuberculosis

Introduction

Introduction to papular necrotizing tuberculosis Papulonecrotic tuberculosis (papulonecrotic tuberculosis) is also known as tuberculosis cultis papulonecrotica. The clinical features are scattered papules on the extremities of the extremities. Central necrosis can form ulcers and scars. The etiology and TCM syndromes show intractable erythema. basic knowledge The proportion of illness: 0.07% Susceptible people: no specific population Mode of infection: non-infectious Complications: tuberculosis, kidney tuberculosis

Cause

The cause of papular necrotic tuberculosis

(1) Causes of the disease

It is generally believed that the Mycobacterium tuberculosis in the disease is spread to the skin by blood and is quickly eliminated by the skin. It is a type of tuberculosis rash. Patients are often accompanied by tuberculosis or other tuberculosis in the body, or with other skin tuberculosis, tuberculosis. The bacteriocin test was strongly positive, but no tuberculosis was found in the lesion.

(two) pathogenesis

It is generally believed that the Mycobacterium tuberculosis in this disease is spread to the skin by blood and is quickly eliminated by the skin. It is a type of tuberculosis.

Prevention

Pimple necrotizing 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

Pimple necrotizing tuberculosis complication Complications, tuberculosis, kidney tuberculosis

Patients with low resistance can concurrently develop tuberculosis in other parts of the body, such as tuberculosis (often with low fever, night sweats, history of wasting), peritoneal tuberculosis, lymph node tuberculosis, bone tuberculosis, kidney tuberculosis, etc., and further improvement of chest X-ray, B in clinical diagnosis and treatment Super, as well as CT, MRI and other tests for comprehensive analysis and judgment to determine whether there are tuberculosis complications in the above-mentioned areas. At the same time, it needs to be differentiated from other ulcerative skin diseases, which can be confirmed according to the auxiliary examination such as puncture pathological biopsy.

Symptom

Papular necrotizing tuberculosis symptoms common symptoms papular reticular pigmentation depression scars

From the beginning, there are scattered red or bright red rice granules, which gradually increase to high glutinous grains or peas, and the color turns brown or dark red. Soon, the center is necrotic, covered with brown fixed suede, and small ulcers can be seen after removal. After the healing, it forms a depressed scar, with dark brown pigmentation, and it does not retreat for a long time. Most of the symmetry occurs on the extremities of the extremities, especially near the knee and elbow joints and the calves (Fig. 1), or between the fingers and the back of the hand. Limited to hair follicles, known as ollicles; hairy or neck-like acne or rosacea, known as acnitis, can also spread chest and back and shoulders when multiple, good violation of young women, spring More common in autumn, chronic, repeated attacks, often positive for tuberculin medium dilution (1:10,000 to 1:100,000).

Symptoms of symmetry occur on the extremities of the extremities. The initial appearance is scattered red or red rice with large papules. It gradually enlarges to high granules or peas, and the color turns brown or dark red. Soon, the center is necrotic and covered with brown. Fix the suede, remove the small ulcer, and then form a depressed scar, dark brown pigmentation, long-lasting, histopathology: with the different stages of the disease, the changes are different, you can diagnose.

Examine

Examination of papular necrotic tuberculosis

Histopathology: The changes are different depending on the stage of the lesion. The initial rash is leukocyte-ruptured vasculitis, which is typically characterized by wedge-shaped necrotic areas and the entire epidermis. There are epithelial-like cells and Langhansian giant cells infiltrating. The middle and lower vascular layers of the dermis are damaged, which is characterized by endocarditis and thrombosis.

Diagnosis

Diagnosis and diagnosis of papular necrotic tuberculosis

Diagnostic identification

Gangrenous acne

For painless follicular papules and pustules, there is often central necrosis, which results in depressed scars, mainly in the forehead, cheeks, infiltration, and more with young acne, and acne.

2. Acne-like syphilis

Pustules form on the top of the papules, which are scattered throughout the body. They are more common in middle age, and the syphilis serum reaction is strongly positive.

3. Hair follicle impetigo

It can be similar to those of the extremities, but the pustules are consistent with the hair follicles, without central gangrene, and the contact is contagious and short.

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