Lupus

Skin tuberculosis is one of the forms of tuberculosis that occurs when tuberculous mycobacteria penetrate the skin and subcutaneous tissue. It belongs to a group of dermatoses that can manifest with various symptoms depending on the form of the lesion.

In almost all cases, tuberculous skin lesions are secondary and endogenous. This means that the pathogen usually enters the skin and subcutaneous tissue through the lymphohematogenous route from foci of tuberculosis in other organs; sometimes the infection penetrates the skin along its length - from affected neighboring organs. Exogenous infection of the skin occurs very rarely - through its damage.

There are focal and disseminated forms of skin tuberculosis. Focal forms include lupus vulgaris, scrofuloderma, verrucous and ulcerative tuberculosis. Disseminated forms are papulonecrotic tuberculosis and erythema induratum.

Vulgar (ordinary, tuberculous) lupus usually occurs at school age with the appearance of several lupomas - small yellowish-pink flat soft tubercles that reveal translucent yellowness on diascopy (the “apple jelly” phenomenon), and when pressed with a button probe - extreme softness and vulnerability (the phenomenon "probe") Gradually, lipomas increase in size and number, and can become covered with scales and ulcerate. After healing of ulcers or resorption of lipomas, thin, smooth, white atrophic scars remain, resembling crumpled tissue paper. Favorite localization: face (nose, upper lip, cheeks, ears), buttocks, limbs. The mucous membrane of the oral cavity is often affected, where the process usually becomes ulcerative in nature, and the ulcers are painful.

With scrofuloderma (colliquatic tuberculosis of the skin) it is observed mainly in children and adolescents suffering from tuberculosis of the subcutaneous lymph nodes, from which the process passes to the subcutaneous fatty tissue; infection can also occur by hematogenous route. In the submandibular region, on the neck, chest, and limbs, single or multiple bluish-red nodes appear with gradual softening and collapse of the center, the formation of a fibrous capsule, sometimes with the formation of fistulas. When the nodes soften, caseous material may be released from them. In the disseminated form of scrofuloderma, multiple areas of the skin are affected.

Warty skin tuberculosis is characterized by the appearance of multiple, pointed, dense, bumpy formations on the skin, resembling warts. They can be located both on open areas of the skin and on the mucous membranes of the oral cavity and genitals. With a long course, ulcerative and cicatricial changes are possible.

Ulcerative tuberculosis of the skin is manifested by the appearance of deep ulcers with uneven edges, a bottom covered with dirty yellow, sticky masses. They usually expand slowly and heal to form large, deep scars.

Papulonecrotic tuberculosis of the skin is manifested by the appearance of multiple, painful, dense papules on the skin, which then develop into ulcers with a necrotic bottom. In the disseminated form, multiple areas of skin are affected.

Erythema induratum is manifested by the appearance of compacted, reddened areas of skin, which can have different shapes and sizes. They are usually not painful and do not heal with scarring.

To diagnose skin tuberculosis, clinical, immunological, bacteriological and histological studies are carried out. Treatment of skin tuberculosis is carried out using antibacterial drugs, which are selected depending on the form and stage of the disease.

Skin tuberculosis (tuberculosis cutis; synonym: radiation dermatitis) is a skin form of tuberculosis infection that is caused by a specific microorganism - Mycobacterium tuberculosis. Some cases of skin tuberculosis occur through contact spread of the pathogen from patients with primary tuberculosis. In terms of its manifestations and complications, it is a serious dermatosis with a high risk of transition to an active tuberculosis process. Symptoms of tuberculous dermatitis are represented by dry or moist superficial skin lesions, maculopapular rashes on open areas of the body and, in the presence of an ulcer, chancre with the formation of fistulas and scars. The onset of the disease is gradual or acute. Pathogenesis is caused by delayed-type hypersensitivity reactions and immunological sensitization to mycobacteria; less commonly, it can occur due to infection with Koch's bacillus from a carrier of mycobacterium tuberculosis of the gastrointestinal tract. Treatment is carried out in specialized inpatient departments (mainly anti-tuberculosis departments), therapy is possible on an outpatient basis or at home.

The skin is most sensitive to Mycobacterium tuberculosis, being affected in every tenth encounter. Skin lesions can appear from the very beginning of the disease or many years after the latent course of the tuberculosis process. Generalized forms of tuberculosis, tuberculous meningitis, as well as latent (minor) forms