Tuberculosis and Respiratory Diseases

  • 제62권6호
  • /
  • Pages.536-539
  • /
  • 2007
  • /
  • 1738-3536(pISSN)
  • /
  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
권호 표지

구진괴사성 결핵진을 동반한 결핵성 림프절염 1예

A Case of Tuberculous Lymphadenitis accompanying Papulonecrotic Tuberculid

  • 한태영 (중앙대학교 의과대학 피부과학교실) ;
  • 김지영 (중앙대학교 의과대학 피부과학교실) ;
  • 곽희원 (중앙대학교 의과대학 내과학교실) ;
  • 최재철 (중앙대학교 의과대학 내과학교실) ;
  • 신종욱 (중앙대학교 의과대학 내과학교실) ;
  • 김재열 (중앙대학교 의과대학 내과학교실) ;
  • 박인원 (중앙대학교 의과대학 내과학교실) ;
  • 김명남 (중앙대학교 의과대학 피부과학교실) ;
  • 최병휘 (중앙대학교 의과대학 내과학교실)
  • Han, Tae Young (Department of Dermatology, College of Medicine, Chung-Ang University) ;
  • Kim, Ji Young (Department of Dermatology, College of Medicine, Chung-Ang University) ;
  • Kwak, Hee Won (Department of Internal Medicine, College of Medicine, Chung-Ang University) ;
  • Choi, Jae Chul (Department of Internal Medicine, College of Medicine, Chung-Ang University) ;
  • Shin, Jong Wook (Department of Internal Medicine, College of Medicine, Chung-Ang University) ;
  • Kim, Jae Yeol (Department of Internal Medicine, College of Medicine, Chung-Ang University) ;
  • Park, In Won (Department of Internal Medicine, College of Medicine, Chung-Ang University) ;
  • Kim, Myeung Nam (Department of Dermatology, College of Medicine, Chung-Ang University) ;
  • Choi, Byoung Whui (Department of Internal Medicine, College of Medicine, Chung-Ang University)
  • 투고 : 2007.05.03
  • 심사 : 2007.05.14
  • 발행 : 2007.06.30
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초록

저자들은 경부 림프절 종대와 사지와 손가락의 홍반성 구진을 주소로 내원한 27세 여자 환자에게서 결핵성 림프절염과 구진괴사성 결핵진을 동시에 진단하고 항 결핵 요법을 통해 치유를 보인 1예를 경험하고, 구진괴사성 결핵진의 정확한 이해와 진단이 결핵 환자의 발견에 도움이 될 것으로 생각되어 문헌 고찰과 함께 보고하는 바이다.

Lymphadenitis is a common manifestation in tuberculous diseases. However, papulonecrotic tuberculid is an uncommon cutaneous manifestation, and is considered an allergic reaction against tuberculous bacilli in tuberculous lesions other than the lymph nodes. A wide great variety of cutaneous manifestations arise over a period of a few weeks - i.e., papules, necrosis, crusted and atrophic scars. We described a 27-year-old woman with right cervical tuberculous lymphadenitis and skin lesions involving her arms, legs and both fingers. Histopathologically, a leukocytoclastic vasculitis with V-shaped epidermal necrosis was observed in the upper and deep dermis, including the good response to anti-tuberculosis therapy support the diagnosis of papulonecrotic tuberculid.

키워드

참고문헌

  1. Mitsuishi T, Iida K, Kawana S. Papulonecrotic tuber- uclid with spontaneous remission. J Dermatol 2006; 33:112-4 https://doi.org/10.1111/j.1346-8138.2006.00023.x
  2. Morrison JG, Fourie ED. The papulonecrotic tuber- culide. From Arthus reaction w lupus vulgaris. Br J Dermatol 1974;91:263-70 https://doi.org/10.1111/j.1365-2133.1974.tb12894.x
  3. Oh ST, Lee HJ, Yoon DH, Kim JW. A case of papulonecrotic tuberculid combined with erythema induratum. Korean J Dermatol 1999;37:1703-5
  4. Williams JT. Pulitzer DR, DeVillez RL. Papulone- crotic tuberculid secondary to disseminated Mycobacterium avinum complex. Int J Dermatol 1994;33:109-12 https://doi.org/10.1111/j.1365-4362.1994.tb01537.x
  5. Sehgal VN. Cutaneous tuberculosis. Dermatol Clin 1994;12:645-63 https://doi.org/10.1016/S0733-8635(18)30128-1
  6. Jordaan HF, Van Niekerk DJ, Louw M. Papulone- crotic tuberculid. A clinical, histopathological, and immunohistochemical study of 15 patients. Am J Dermatopathol 1994;16:474-85 https://doi.org/10.1097/00000372-199410000-00002
  7. Barbagallo J. Tager P, Ingleton R, Hirsch RJ, Wein- berg JM. Cutaneous tuberculosis: dignosis and treatment. Am J Clin Dermatol 2002;3:319-28 https://doi.org/10.2165/00128071-200203050-00004
  8. Chuang YH, Kuo TT, Wang CM, Wang CN, Wong WR, Chan HL. Simultaneous occurrence of papulonecrotic tuberculide and erythema induratum and the identification of Mycobacterium tuberculosis DNA by polymerase chain reaction. Br J Dermatol 1997; 137:276-81 https://doi.org/10.1046/j.1365-2133.1997.18201916.x
  9. Sehgal VN, Bhattacharya SN, Jain S, Logani K. Cutaneous tuberculosis: the evolving scenario. Int J Dermatol 1994;33:97-104 https://doi.org/10.1111/j.1365-4362.1994.tb01534.x
  10. Kakakhel KU, Fritsch P. Cutaneous tuberculosis. Int J Dermatol 1989;28:355-62 https://doi.org/10.1111/j.1365-4362.1989.tb02478.x
  11. Yoon DJ, Ihm CW. Clinicopatholgical comparison of papulonecrotic tuberculid and pityriasis lichenoides et varioliformis acuta. Korean J Dermatol 1982;20: 667-75