印度儿童的皮肤结核:筛查受累的内脏器官的重要性
Cutaneous tuberculosis in Indian children: The importance of screening for involvement of internal organs作者机构：B-1/1101 Vasant Kunj New Delhi-110070 India
出 版 物：《世界核心医学期刊文摘（皮肤病学分册）》 (Digest of the World Core Medical JOurnals:Dermatology)
年 卷 期：2005年第1卷第2期
页 面：51-52页
学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学]
主 题：皮肤结核 儿童发病率 病理学检查 瘰疬性苔藓 耐药病例 可疑病例 结核杆菌培养 寻常狼疮 检查和 曼托
摘 要：Aims and objectives. Resurgence of skin tuberculosis especially with drug-resistant strains has been well documented in recent years, but this problem has not received much attention in the paediatric age group. Hence, we carried out the present study to analyse the clinical and therapeutic aspects of cutaneous tuberculosis in children. Materials and methods. A detailed clinical examination, investigations, such as haemogram, serology for HIV, Mantoux test, chest X-ray, cytology, culture and histopathologywere carried out in all children. They were treated with antitubercular therapy (WHO regimen), and the clinical response was followed up. Results. Of 142 patients with cutaneous tuberculosis, 68 were children (40 females, 28 males). These children were aged from 9 months to 14 years. The duration of the disease varied from 1 month to 6 years. Family history of tuberculosis was present in 28 (41.2%) of the patients. Scrofulodermawas themost commonpresentation encountered in 30 (44.1%) patients with preferential involvement of the cervical (56.2%) and inguinal (20%) regions. Fifteen (22.1%) patients had lupus vulgaris, of which the keratotic type was the most common (46.7%), 16 had lichen scrofulosorum, three had tuberculosis verrucosa cutis, and four had more than one type of tuberculosis. Involvement of the lung in 14 (20.6%), bone in seven (10.2%), and both in four (5.9%) was found. Histopathology corroborated the clinical diagnosis in 54 (80.6%), culture was positive in six (8.8%). Fifty (73.5%)-patients completed the treatment with an excellent response, no multi-drug resistant cases were seen. Conclusions. Cutaneous tuberculosis in children continues to be an important cause of morbidity, there is a high likelihood of internal involvement, especially in patients with scrofuloderma. A search is required for more sensitive, economic diagnostic tools. Response to treatment at 4 weeks often helps in substantiating the diagnosis of tuberculosis in doubtful cases.
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