皮膚結核－病例報告

Cutaneous Tuberculosis: A Case Report

10.7023/TJFM.200509.0172

黃偉新(Wei-Hsin Huang)；蔡悅琪(Yueh-Chi Tsai)；黃麗卿(Lee-Ching Hwang)；鍾嫈嫈(Jin-Jin Tjung)；林揚志(Yang-Chih Lin)；李聰明(Chun-Ming Lee)；曾嶔元(Chin-Yuan Tzen)

extrapulmonary tuberculosis ； cutaneous tuberculosis

台灣家庭醫學雜誌

15卷3期（2005 / 09 / 01）

172 - 180

繁體中文

結核病在沉寂許久後，最近十年於全世界又有慢慢攀升的趨勢，這已變成重要的公共衛生課題。根據統計，在台灣所有的結核病例中，約有十分之一是屬於肺外結核。台灣肺外結核侵犯的位置以肋膜最為常見，而皮膚結核約佔肺外結核不到百分之一。皮膚結核在臨床上的表現多樣，加上病例報告稀少，因此病人常常無法得到正確的診斷與治療。本篇報告是探討一位糖尿病病患合併腿部皮膚潰瘍，經過基層醫師給予切開清除及抗生素治療後卻未見痊癒，甚至又有新的病灶產生。最後在本院家醫科醫師建議下接受皮膚切片，切片的病理檢查與PCR均證實為皮膚結核，給予抗結核藥物治療後完全痊癒。本文的目的希望藉此病例及文獻回顧能讓基層醫師對於皮膚結核有進一步的認識。

After several decades of silence, the increasing prevalence of tuberculosis around the world in the past ten years has become an important issue in public health. According to the statistics in Taiwan, extrapulmonary tuberculosis accounts for about ten percent of total tuberculosis cases. Pleura is the most invaded site by extrapulmonary tuberculosis, among which cutaneous tuberculosis is only less than one percent. Patients are often not properly diagnosed and treated due to the various clinical presentations of cutaneous tuberculosis and rare case reports. This case discusses a diabetic patient whose leg ulcer did not recovered after being treated with excision and antibiotics. The family doctor suggested to him to receive skin biopsy, where pathologic and PCR results both confirmed the diagnosis of cutaneous tuberculosis, and the leg ulcer has thus recovered after antituberculosis therapy. With this case and relevant documents, this article is intended to provide doctors with further knowledge on the cutaneous tuberculosis.