Misdiagnosis Analysis of 8 Cases of Ulcerative Cutaneous Tuberculosis

NUERBAOLATI Aman; AHETIBIEKE Tabusi; LI Jian-hui; LI Jian-gang; ZHOU Jun; ABUDOUSIMU Aisha; MA Bo; CHEN Zhao-hui

doi:10.3969/j.issn.1002-3429.2016.02.004

Abstract：Objective To discuss clinical characteristics, misdiagnosis factors and preventive measures of the ulcera-tive skin tuberculosis. Methods Clinical data of 8 misdiagnosed cases of cutaneous tuberculosis ulcerosa admitted into the Second Affiliated Hospital of Xinjiang Medical University during June 2005 and June 2014 were retrospectively analyzed. Re-sults Common characteristics of these 8 cases were that all the lesions occurred on the lower limb. It was manifested in the local skin from erythema, papules and nodules at the beginning of the disease, and then developed into ulcer, erosion, swell-ing and pain, with no symptoms of systemic tuberculosis poisoning. There were 4 cases of lower limb varicose ulcer, 2 cases of lower limb skin cancers and 2 cases of Bowen's disease were first treated and misdiagnosed by other hospitals. The misdiagno-sis duration was 5 to 36 months, with an average time of 20. 5 months. Upon admission to our hospital, 7 cases were diagnosed according to the medical history, clinical manifestation, the PPD test, Tuberculosis T lymphocytes spot test ( T-SPOT. TB) , ulcer lesions secretions mycobacterium tuberculosis acid-fast stain and pathological examination. However, 1 case was con-firmed after diagnostic anti-tuberculosis treatment, instead of the pathological diagnosis. Each case was provided with the standard anti-tuberculosis treatment for 11 months, local lesions were treated for 6 to 9 months, without skin-grafting. Fol-lowed up for 12 to 18 months, the patients had no recurrence. Conclusion The cutaneous tuberculosis ulcerous is rare with-out obvious clinical manifestations and tends to be misdiagnosed. In treatment of this disease with a long course or persistent uncured leg ulcers clinicians should consider cutaneous tuberculosis ulcerosa and make pathological examination. If necessary, diagnostic anti-tuberculosis treatment should be given for the benefit of early confimation.