- 期刊
Disseminated Lupus Vulgaris with Clinical Manifestations of Classical Plaque, Cicatricial Alopecia and Chronic Ulcer
以典型斑塊、疤痕性禿髮及慢性潰瘍為表現的散播性尋常性狼瘡
摘要
尋常性狼瘡是一種緩慢進展的皮膚結核病，多發生在具有中度至高度免疫力的個體。通常是由內部器官的結核感染蔓延而來。其多為單一病灶並好發於頭頸部。我們在此報告一例罹患轉移性乳癌的六十五歲女性病患，身上發生多處的皮膚病灶。其右大腿有一持續兩年的潰瘍性病灶。頭皮有兩塊暗紅色的板塊樣病灶合併疤痕性禿髮的表現，在左側下顎則另有一板塊樣病灶，這些都已有一年的時間。組織病理下可見由蘭罕氏巨細胞及上皮樣組織細胞所構成的結核性肉芽腫。頭皮病灶處的組織培養證實是結核菌感染。在符合尋常性狼瘡的診斷之下，給予抗結核藥物isoniazid及ethambutol，其病灶在兩個月內逐漸癒合。治療持續了七個月，直至病人死於乳癌轉移後的併發症。
關鍵字
無資料並列摘要
Lupus vulgaris (LV) is a chronic and progressive form of cutaneous tuberculosis occurring in individual with a moderate to high degree of immunity. It generally arises from endogenous spread of tuberculosis of other organs. The lesions are usually solitary and affect the head and neck. We report a 65-year-old woman with a history of metastatic breast cancer who showed multiple lesions on different skin areas. There was an ulcerated lesion on the right thigh for about two years. Two large dusky red plaques on the scalp with scarring alopecia and another plaque on the left jaw were noted for about one year. The report of histopathology showed non-caseating tuberculoid granuloma composed of Langhans giant cells and epithelioid histiocytes. Tissue culture from the scalp lesion grew Mycobacteria tuberculosis. Under the impression of disseminated LV, an antituberculous therapy comprising isoniazid and ethambutol was prescribed. All the skin lesions healed gradually with residual scarring in 2 months. The patient continued the antituberculous therapy for 7 months until she died of the complications of breast cancer metastasis.