tuberculosis cutis(lupus vulgaris)

蔡呈芳醫師(www.DrSkin.com.tw)

臨床上皮膚肺結核感染主要有以下表現方式

細菌活化: 腺病瘡(scrofuloderma)

細菌再次感染：疣樣皮膚結核(tuberculosis verrucosa cutis)、尋常性狼瘡(Lupus vulgaris)

尋常性狼瘡是尋常性狼瘡一種具侵略性的表皮結核菌感染，發生於具中等抵抗力以上的宿主，有多種臨床表現型式，典型病灶為一由多個節結組成的斑塊，呈現蘋果果醬(apple jelly)色澤。長期不癒的情況下可能演變為扁平細胞癌。

 

Bacterial load	Route	Disease
Multibacillary forms	By direct inoculation	Primary inoculation TB (tuberculous chancre)
	By continuity	Scrofuloderma
		Tuberculosis periorificialis
	By hematogenous spreading	Acute miliary tuberculosis
		Gumma (cold abscess)
Paucibacillary forms	By direct inoculation (re-exposure)	Tuberculosis verrucosa cutis
		Lupus vulgaris (occasionally)
	By hematogenous spreading	Lupus vulgaris

TB verrucosa