The Experts below are selected from a list of 246 Experts worldwide ranked by ideXlab platform
Chee-khin Chin - One of the best experts on this subject based on the ideXlab platform.
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Papulonecrotic Tuberculid with positive acid fast bacilli
Pathology, 2015Co-Authors: Joon-joon Khoo, Chee-khin ChinAbstract:Introduction Tuberculosis is a common infection in immunosuppressed patients. The causative organism is Mycobacterium tuberculosis. Lungs are the commoner site of infection. Papulonecrotic Tuberculid (PNT) is a very rare form of cutaneous tuberculosis. Case report We describe a 24-year-old male with end-stage renal disease who had renal transplant. He was on prednisolone, azathioprine and cyclosporin. Six years after the transplantation, he presented with enlarging, painful, erythematous nodules at the dorsum of his feet over a period of 2 months. The nodules ulcerated, were extremely tender and had purulent discharge. The edges were undermined. Cytology smears from the lesions showed acid fast bacilli. The histopathological examination of the lesion showed features consistent with Papulonecrotic Tuberculid. He had no evidence of active tuberculosis in the lung or elsewhere. He was treated with the anti-tuberculosis regime together with adjustment of the immune-supressants. The ulcers healed well with no recurrence on follow-up. Discussion Direct proof with presence of AFB in the lesion supports the theory that the organism is responsible for development of PNT and not as previously thought to be due to hypersensitivity reaction to the Mycobacterium antigens or an allergic reaction. Prompt response to anti-tuberculosis treatment is the hallmark of PNT.
Jeffrey M. Weinberg - One of the best experts on this subject based on the ideXlab platform.
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Cutaneous Tuberculosis
American Journal of Clinical Dermatology, 2002Co-Authors: Joseph Barbagallo, Patricia Tager, Rosemary Ingleton, Ranella J. Hirsch, Jeffrey M. WeinbergAbstract:As we move into the 21st century, cutaneous tuberculosis has re-emerged in areas with a high incidence of HIV infection and multi-drug resistant pulmonary tuberculosis. Mycobacterium tuberculosis , Mycobacterium bovis , and the BCG vaccine cause tuberculosis involving the skin. True cutaneous tuberculosis lesions can be acquired either exogenously or endogenously, show a wide spectrum of morphology and M. tuberculosis can be diagnosed by acid-fast bacilli (AFB) stains, culture or polymerase chain reaction (PCR). These lesions include tuberculous chancre, tuberculosis verrucosa cutis, lupus vulgaris, scrofuloderma, orificial tuberculosis, miliary tuberculosis, metastatic tuberculosis abscess and most cases of Papulonecrotic Tuberculid. The Tuberculids, like cutaneous tuberculosis, show a wide spectrum of morphology but M. tuberculosis is not identified by AFB stains, culture or PCR. These lesions include lichen scrofulosorum, nodular Tuberculid, most cases of nodular granulomatous phlebitis, most cases of erythema induratum of Bazin and some cases of Papulonecrotic Tuberculid. Diagnosis of cutaneous tuberculosis is challenging and requires the correlation of clinical findings with diagnostic testing; in addition to traditional AFB smears and cultures, there has been increased utilization of PCR because of its rapidity, sensitivity and specificity. Since most cases of cutaneous tuberculosis are a manifestation of systemic involvement, and the bacillary load in cutaneous tuberculosis is usually less than in pulmonary tuberculosis, treatment regimens are similar to that of tuberculosis in general. In the immunocompromised, such as an HIV infected patient with disseminated miliary tuberculosis, rapid diagnosis and prompt initiation of treatment are paramount. Unfortunately, despite even the most aggressive efforts, the prognosis in these individuals is poor when multi-drug resistant mycobacterium are present. An increased awareness of the re-emergence of cutaneous tuberculosis will allow for the proper diagnosis and management of this increasingly common skin disorder.
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Cutaneous tuberculosis: diagnosis and treatment.
American journal of clinical dermatology, 2002Co-Authors: Joseph Barbagallo, Patricia Tager, Rosemary Ingleton, Ranella J. Hirsch, Jeffrey M. WeinbergAbstract:As we move into the 21st century, cutaneous tuberculosis has re-emerged in areas with a high incidence of HIV infection and multi-drug resistant pulmonary tuberculosis. Mycobacterium tuberculosis, Mycobacterium bovis, and the BCG vaccine cause tuberculosis involving the skin. True cutaneous tuberculosis lesions can be acquired either exogenously or endogenously, show a wide spectrum of morphology and M. tuberculosis can be diagnosed by acid-fast bacilli (AFB) stains, culture or polymerase chain reaction (PCR). These lesions include tuberculous chancre, tuberculosis verrucosa cutis, lupus vulgaris, scrofuloderma, orificial tuberculosis, miliary tuberculosis, metastatic tuberculosis abscess and most cases of Papulonecrotic Tuberculid. The Tuberculids, like cutaneous tuberculosis, show a wide spectrum of morphology but M. tuberculosis is not identified by AFB stains, culture or PCR. These lesions include lichen scrofulosorum, nodular Tuberculid, most cases of nodular granulomatous phlebitis, most cases of erythema induratum of Bazin and some cases of Papulonecrotic Tuberculid. Diagnosis of cutaneous tuberculosis is challenging and requires the correlation of clinical findings with diagnostic testing; in addition to traditional AFB smears and cultures, there has been increased utilization of PCR because of its rapidity, sensitivity and specificity. Since most cases of cutaneous tuberculosis are a manifestation of systemic involvement, and the bacillary load in cutaneous tuberculosis is usually less than in pulmonary tuberculosis, treatment regimens are similar to that of tuberculosis in general. In the immunocompromised, such as an HIV infected patient with disseminated miliary tuberculosis, rapid diagnosis and prompt initiation of treatment are paramount. Unfortunately, despite even the most aggressive efforts, the prognosis in these individuals is poor when multi-drug resistant mycobacterium are present. An increased awareness of the re-emergence of cutaneous tuberculosis will allow for the proper diagnosis and management of this increasingly common skin disorder.
H H Tseng - One of the best experts on this subject based on the ideXlab platform.
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Papulonecrotic Tuberculid a rare skin manifestation in a patient with pulmonary tuberculosis
Journal of the Formosan Medical Association, 2000Co-Authors: S C Chen, H Y Tao, H H TsengAbstract:Papulonecrotic Tuberculid (PNT), a cutaneous manifestation of tuberculosis, is rare even in areas endemic for tuberculosis such as Taiwan. Concomitant pulmonary tuberculosis is uncommon in patients with PNT. We describe a patient with rare skin manifestations and simultaneous pulmonary tuberculosis. This 48-year-old woman had suffered from productive cough for 4 months, and pea-sized papules with central umbilication were noted over the extensor surface of her four extremities and lower abdomen 1 month prior to admission to our hospital. Chest roentgenography showed reticulonodular lesions with small cavitation over the lower right lung field, and sputum culture yielded Mycobacterium tuberculosis complex. PNT was diagnosed using the skin biopsy results and the papules healed with scar formation after antituberculous therapy.
Joon-joon Khoo - One of the best experts on this subject based on the ideXlab platform.
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Papulonecrotic Tuberculid with positive acid fast bacilli
Pathology, 2015Co-Authors: Joon-joon Khoo, Chee-khin ChinAbstract:Introduction Tuberculosis is a common infection in immunosuppressed patients. The causative organism is Mycobacterium tuberculosis. Lungs are the commoner site of infection. Papulonecrotic Tuberculid (PNT) is a very rare form of cutaneous tuberculosis. Case report We describe a 24-year-old male with end-stage renal disease who had renal transplant. He was on prednisolone, azathioprine and cyclosporin. Six years after the transplantation, he presented with enlarging, painful, erythematous nodules at the dorsum of his feet over a period of 2 months. The nodules ulcerated, were extremely tender and had purulent discharge. The edges were undermined. Cytology smears from the lesions showed acid fast bacilli. The histopathological examination of the lesion showed features consistent with Papulonecrotic Tuberculid. He had no evidence of active tuberculosis in the lung or elsewhere. He was treated with the anti-tuberculosis regime together with adjustment of the immune-supressants. The ulcers healed well with no recurrence on follow-up. Discussion Direct proof with presence of AFB in the lesion supports the theory that the organism is responsible for development of PNT and not as previously thought to be due to hypersensitivity reaction to the Mycobacterium antigens or an allergic reaction. Prompt response to anti-tuberculosis treatment is the hallmark of PNT.
José M. De Moragas - One of the best experts on this subject based on the ideXlab platform.
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Mycobacterium tuberculosis DNA in Papulonecrotic Tuberculid.
Archives of dermatology, 1996Co-Authors: Eulalia Baselga, N. Margall, Maria A. Barnadas, José M. De MoragasAbstract:Papulonecrotic Tuberculid (PNT) is characterized by symmetrically distributed erythematous papules that often ulcerate and heal with a varioliform scar. It affects patients with a moderate-to-high degree of tuberculin hypersensitivity. 1 In the current classification of cutaneous tuberculosis, PNT is included in the group of Tuberculids. The pathogenic relationship between Tuberculids and Mycobacterium tuberculosis has been the subject of controversy, since M tuberculosis has never been cultured from these lesions. For many authors, they represent hypersensitivity reactions to hematogenously disseminated bacilli or mycobacterial antigens. Recently, the DNA of M tuberculosis has been detected by polymerase chain reaction (PCR) amplification in the lesions of PNT and other Tuberculids. 2-4 The aim of this study was to demonstrate the presence of M tuberculosis DNA in the lesions of PNT. Materials and Methods. We selected skin biopsy specimens with histopathologic features consistent with PNT from patients with clinically suggestive lesions and positive tuberculin
