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Tuberculid

Tb Cutan Hypersensitiv React


Presentation

  • Papulonecrotic tuberculid was observed at a very early stage, presenting as molluscum-like lesions. This has been described once in the literature.[ncbi.nlm.nih.gov]
Splenomegaly
  • Additional clinical findings included fever (n 4), hepatomegaly (n 4), lymphadenopathy (n 3), phlyctenular conjunctivitis (n 3), and splenomegaly (n 2).[ncbi.nlm.nih.gov]
Weight Loss
  • Abstract We present a 33-year-old HIV-positive man who presented with a two-year history of a non-itchy papular eruption, associated with night sweats, headaches, poor memory and weight loss.[ncbi.nlm.nih.gov]
  • There was no recognized contact with tuberculosis patients and the patient denied fever, respiratory complaints, anorexia or weight loss. She complained of night sweats and diffuse myalgia and arthralgia going back to several weeks.[docksci.com]
  • She was not suffering from cough, fever, or weight loss. She had no past history of tuberculosis (TB) or contact with case of TB. She had undergone tuberculin testing 2 days back.[cyberleninka.org]
Hunting
  • It cannot be overemphasized that an aggressive search has to be carried out to hunt out the extracutaneous focus or else monitoring the end-point of treatment impossible.[ijdvl.com]
Hepatomegaly
  • Additional clinical findings included fever (n 4), hepatomegaly (n 4), lymphadenopathy (n 3), phlyctenular conjunctivitis (n 3), and splenomegaly (n 2).[ncbi.nlm.nih.gov]
Hepatosplenomegaly
  • There was no evidence of lymphadenopathy and hepatosplenomegaly, and rest of her systemic examination was unremarkable.[cyberleninka.org]
Myalgia
  • She complained of night sweats and diffuse myalgia and arthralgia going back to several weeks. Histopathologic analysis of a skin biopsy showed a dense granulomatous cell infiltrate with necrosis (Figure 2).[docksci.com]
Freckles
  • Figure 1: Freckles (a), after marking (b) with a blue gel pen and treatment (c) using a Q-switched laser VGP-1220 0.5 mm blue pen, M and G Stationery Inc., Shanghai, China) without laser safety glasses.[cyberleninka.org]
Hypopigmented Macule
  • It is most frequent in children.[3] Typically, lichen striatus is characterized by the presence of erythematous, lichenoid papules that generally develop along the lines of Blaschko, although hypopigmented macules and/ or papules may occur in dark-skinned[cyberleninka.org]

Workup

  • These patients require a detailed workup to look for systemic disease and should receive a complete course of multi-drug therapy.[derm101.com]
Mycobacterium Avium Complex
  • Papulonecrotic Tuberculid Secondary to Disseminated Mycobacterium Avium Complex. Int J Dermatol. 1994;33(2):109-12. PubMed PMID: 8157390. TY - JOUR T1 - Papulonecrotic tuberculid secondary to disseminated Mycobacterium avium complex.[unboundmedicine.com]
  • From the cutaneous cultures Mycobacterium avium complex (MAC) organisms were grown. RESULTS: We report the first case of papulonecrotic tuberculid manifestation in an AIDS patient with disseminated MAC.[ncbi.nlm.nih.gov]
  • Seite 370 - Recommendations on prophylaxis and therapy for disseminated Mycobacterium avium complex disease in patients infected with the human immunodeficiency virus. ‎[books.google.de]

Treatment

  • Despite multiple-drug therapy, three cases had recurrences after discontinuation of treatment. Long-term treatment is recommended for the treatment of PNT.[ncbi.nlm.nih.gov]
  • Related Treatment of Skin Disease Comprehensive Therapeutic Strategies 4e[clinicalgate.com]
  • Article Access Statistics Viewed 3972 Printed 63 Emailed 2 PDF Downloaded 0 Comments Prompt response to anti- tuberculosis treatment is its hallmark.[ijdvl.com]
  • Clinical improvement after 2 weeks of treatment. Case Report high prevalence of tuberculosis.[docksci.com]

Prognosis

  • Tuberculoderms, although subject to great clinical variations, have a fairly well established course and prognosis, especially in a specific case in which the characteristics conform strictly to a well recognized type of cutaneous tuberculosis.[jamanetwork.com]
  • Prognosis Without treatment, patients typically follow a waxing and waning course lasting many years, although spontaneous resolution has been reported. Papulonecrotic tuberculids respond promptly to appropriate antituberculosis therapy.[emedicine.medscape.com]
  • […] usually in the lungs) to other organs and tissues via the bloodstream Skin lesions are small (millet-sized) red spots that develop into ulcers and abscesses More likely in immunocompromised patients, eg HIV , AIDS, cancer The patient is generally sick Prognosis[dermnetnz.org]

Etiology

  • The clinical and histologic picture of the entity is a distinctive one, but the etiology of the disease process is uncertain. Therapy directed against the causative organism is dramatically successful.[ncbi.nlm.nih.gov]
  • One is a 43-year-old woman with lymphadenitis tuberculosa, and the other is a 54-year-old man with penis tuberculid and epididymitis of possible tuberculous etiology.[eurekamag.com]
  • However, unlike true cutaneous tuberculosis, M. tuberculosis is not detected within the lesions of tuberculids. [1] Currently, papulonecrotic tuberculid refers to conditions in which reasonable evidence supports M. tuberculosis etiology.[cmj.yiigle.com]
  • Etiology The eruption is a form of an exaggerated host immunologic response to a mycobacterial infection involving the cutaneous vessels. Active tuberculosis is reported in as many as 40-75% of patients, [6] most commonly in lymph nodes.[emedicine.medscape.com]

Epidemiology

  • We review the epidemiology, clinicopathologic features, and differential diagnosis of papulonecrotic tuberculid. Awareness of this entity is important to distinguish it from other conditions and to institute appropriate therapy in a timely fashion.[ncbi.nlm.nih.gov]
  • @inproceedings{Chan2000TuberculideA, title {Tuberculide - A Clinical and Epidemiological Review}, author {Kaai Tung Chan}, year {2000} } Kaai Tung Chan Published 2000 Tuberculide is a rare cutaneous disorder but its recognition is important as it is a[semanticscholar.org]
  • In a series of 12 cases in India, PCR positivity was found in 25% of the cases. [5] Epidemiology Frequency United States A decreasing incidence of papulonecrotic tuberculid began in the second half of the 1900s and the decline continues to this day.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Most patients react markedly to the Mantoux skin test (purified protein derivative [PPD]), may exhibit other evidence of current or past tuberculosis infection, and react quickly to antituberculous therapy. [3, 4] Pathophysiology The pathophysiology of[emedicine.medscape.com]
  • The underlying focus may not be evident at that time. [3] The pathophysiology of this condition is controversial.[idoj.in]
  • Keywords Neurology electrophysiology evoked potentials neuropathology neurophysiology neurosurgery pathophysiology physiology sensory function spinal cord injury spinal cord regeneration surgery trauma Editors and affiliations Erik Stålberg 1 Hari Shanker[link.springer.com]

Prevention

  • Bacille de Calmette et Guerin (BCG) is the only licensed tuberculosis vaccine to prevent severe tuberculosis.[ncbi.nlm.nih.gov]
  • Early diagnosis is essential, to prevent further spread of disease.[clinicalgate.com]
  • Chapter 69 Surrogate Markers of Antiretroviral Efficacy 826 Overcoming Barriers to Providing ARV Therapy in ResourceLimited Settings 831 Chapter 71 Antiretroviral Drugs for HIV Prevention 836 Chapter 72 Acute HIV Infection 843 Chapter 73 Opportunistic[books.google.com]
  • We investigated the ability of an orally active EET analog, EET-A to prevent kidney injury in a mouse SLE model.[medworm.com]

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