TY - JOUR
T1 - Skin biopsy
T2 - A pillar in the identification of cutaneous Mycobacterium tuberculosis infection
AU - Solis, Alejandro Hernández
AU - González, Norma Estela Herrera
AU - Cazarez, Fernando
AU - Pérez, Patricia Mercadillo
AU - Diaz, Hiram Olivera
AU - Escobar-Gutierrez, Alejandro
AU - Ortiz, Ileana Cortés
AU - González, Heleodora González
AU - Reding-Bernal, Arturo
AU - Sabido, Raúl Cícero
PY - 2012/8
Y1 - 2012/8
N2 - Introduction: The present study aimed to establish the frequency and clinical characteristics of cutaneous tuberculosis among Mexican adult patients. Methodology: Ninety-five patients with clinically compatible lesions to cutaneous tuberculosis participated in the study. All patients were HIV negative and none of them had previous anti-TB treatment. A skin biopsy was taken from every patient suspected of having tuberculosis, and a histopathologic examination was performed as follows: Ziehl-Neelsen staining; culturing of mycobacteria by LöwensteinJensen (L-J) medium; Mycobacteria Growth Indicator Tube detection via BACTEC (MGIT-360); and polymerase chain reaction (PCR) with the sequence of insertion IS6110 for Mycobacterium tuberculosis complex. Results: Tuberculosis was confirmed in 65 out of 95cases (68.4%). Identified lesions were scrofuloderma (42 cases, 64.6%); lupus vulgaris (12 cases, 18.4%); warty tuberculosis (six cases, 9.2%); and papulonecrotic tuberculoid (five cases; 7.7%). The Ziehl-Neelsen staining was positive for acid fast bacilli in nine cases (13.8%) and 48 patients were positive for the PCR amplification (73.8%). All skin biopsies resulted positive for tuberculosis. A positive clinical response to the specific treatment was considered a confirmation for tuberculosis. The noninfectious etiology corresponded to 30 cases (31.6%). Conclusions: Tuberculosis in developing countries is still an important cause of skin lesions which must be studied via histopathological examination and culture due to their low bacillary load. A PCR test is necessary to obtain faster confirmation of the disease and to establish an early, specific and effective treatment.
AB - Introduction: The present study aimed to establish the frequency and clinical characteristics of cutaneous tuberculosis among Mexican adult patients. Methodology: Ninety-five patients with clinically compatible lesions to cutaneous tuberculosis participated in the study. All patients were HIV negative and none of them had previous anti-TB treatment. A skin biopsy was taken from every patient suspected of having tuberculosis, and a histopathologic examination was performed as follows: Ziehl-Neelsen staining; culturing of mycobacteria by LöwensteinJensen (L-J) medium; Mycobacteria Growth Indicator Tube detection via BACTEC (MGIT-360); and polymerase chain reaction (PCR) with the sequence of insertion IS6110 for Mycobacterium tuberculosis complex. Results: Tuberculosis was confirmed in 65 out of 95cases (68.4%). Identified lesions were scrofuloderma (42 cases, 64.6%); lupus vulgaris (12 cases, 18.4%); warty tuberculosis (six cases, 9.2%); and papulonecrotic tuberculoid (five cases; 7.7%). The Ziehl-Neelsen staining was positive for acid fast bacilli in nine cases (13.8%) and 48 patients were positive for the PCR amplification (73.8%). All skin biopsies resulted positive for tuberculosis. A positive clinical response to the specific treatment was considered a confirmation for tuberculosis. The noninfectious etiology corresponded to 30 cases (31.6%). Conclusions: Tuberculosis in developing countries is still an important cause of skin lesions which must be studied via histopathological examination and culture due to their low bacillary load. A PCR test is necessary to obtain faster confirmation of the disease and to establish an early, specific and effective treatment.
KW - Cutaneous tuberculosis
KW - Mycobacterium tuberculosis
KW - Polymerase chain reaction (PCR)
UR - http://www.scopus.com/inward/record.url?scp=84869016897&partnerID=8YFLogxK
U2 - 10.3855/jidc.2729
DO - 10.3855/jidc.2729
M3 - Artículo
SN - 1972-2680
VL - 6
SP - 626
EP - 631
JO - Journal of Infection in Developing Countries
JF - Journal of Infection in Developing Countries
IS - 8
ER -