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Temporal differences of onset between primary skin lesions and regional lymph node lesions for tularemia in Japan: a clinicopathologic and immunohistochemical study of 19 skin cases and 54 lymph node cases

机译:日本Tularemia的原发性皮肤病变与局部淋巴结病变的发病时间差异:19例皮肤病例和54例淋巴结病例的临床病理和免疫组织化学研究

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摘要

For tularemia, a zoonosis caused by the gram-negative coccobacillus Francisella tularensis, research of the relation between skin lesions and lymph node lesions has not been reported in the literature. This report describes skin lesions and lymph node lesions and their mutual relation over time for tularemia in Japan. Around the second day after infection (DAI), a subcutaneous abscess was observed (abscess form). Hand and finger skin ulcers formed during the second to the fourth week. Subcutaneous and dermal granulomas were observed with adjacent monocytoid B lymphocytes (MBLs) (abscess–granulomatous form). From the sixth week, large granulomas with central homogeneous lesions emerged diffusely (granulomatous form). On 2–14 DAI, F. tularensis antigen in skin lesions was detected in abscesses. During 7–12 DAI, abscesses with adjacent MBLs appeared without epithelioid granuloma (abscess form) in regional lymph nodes. During the second to fifth week, granulomas appeared with necrosis (abscess–granulomatous form). After the sixth week, large granulomas with a central homogeneous lesion (granulomatous form) appeared. F. tularensis antigen in lymph node lesions was observed in the abscess on 7–92 DAI. Apparently, F. tularensis penetrates the finger skin immediately after contact with infected hares. Subsequently, the primary lesion gradually transfers from skin to regional lymph nodes. The regional lymph node lesions induced by skin lesion are designated as dermatopathic lymphadenopathy. This study revealed temporal differences of onset among the skin and lymph node lesions.
机译:对于tularemia,一种由革兰氏阴性球菌Francisella tularensis引起的人畜共患病,尚无关于皮肤病变与淋巴结病变之间关系的研究。该报告描述了日本的Tularemia的皮肤病变和淋巴结病变及其随时间的相互关系。感染后第二天(DAI),观察到皮下脓肿(脓肿形式)。在第二至第四周形成手和手指皮肤溃疡。皮下和真皮肉芽肿观察到邻近的单核细胞B淋巴细胞(MBLs)(脓肿-肉芽肿形式)。从第六周开始,具有中央均质病变的大肉芽肿扩散出现(肉芽肿状)。在2–14 DAI上,脓肿中检测到皮肤病中的T. tularensis抗原。在7–12 DAI期间,在区域淋巴结中出现邻近MBL的脓肿而无上皮样肉芽肿(脓肿形式)。在第二至第五周,肉芽肿出现坏死(脓肿-肉芽肿形式)。第六周后,出现具有中央均一病变(肉芽肿状)的大型肉芽肿。在7–92 DAI的脓肿中观察到淋巴结病变中的F. tularensis抗原。显然,土拉弗朗西斯菌(F. tularensis)在接触被感染的野兔后立即渗透到手指皮肤中。随后,原发灶逐渐从皮肤转移到局部淋巴结。由皮肤病变引起的局部淋巴结病变被称为皮肤病性淋巴结病。这项研究揭示了皮肤和淋巴结病变之间发病的时间差异。

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