Papulonecrotic tuberculid: A neglected disease in Western countries - 06/10/17
Résumé |
Papulonecrotic tuberculid was diagnosed in twelve young patients demonstrating symmetric scattered papulopustular necrotic lesions of the extremities. The diagnosis was supported by a strongly positive Mantoux reaction in all cases, evidence of preexisting or past tuberculosis in eight patients, characteristic histologic findings, and a prompt resolution with antituberculosis therapy. Recurrence of the skin lesions in three patients treated only with isoniazid or with para-aminosalicylic acid and isoniazid indicates the necessity for combination treatment with several antituberculosis drugs. A detailed study of twenty biopsies indicates that the primary lesion is a subacute lymphohistiocytic vasculitis that causes thrombosis and destruction of small dermal vessels. These changes lead to an infarctlike lesion with coagulation necrosis of dermal tissue. In eleven instances a well-marked palisaded histiocytic reaction was seen around necrotic areas, calling into question the differential diagnosis of granuloma annulare or Churg-Strauss granulomatosis.
Le texte complet de cet article est disponible en PDF. Supported in part by the Eleanor Naylor Dana Charitable Trust and the Kieckhefer Foundation |
Vol 14 - N° 5P1
P. 815-826 - mai 1986 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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