Association of lupus vulgaris and multifocal tuberculous dactylitis and arthritis with multiple tuberculous scars.

摘要

Lupus vulgaris is usually the result of dissemination from an endogenous focus during a period of lowered resistance and mycobacterium tuberculous bacillemia in a previously sensitized host with a strongly positive delayed hypersensitivity to tuberculin. The spread is mostly hematogenous or lymphatic. Approximately 2-3% of osteoarticular tuberculous (TB) is tuberculous osteomyelitis which is commonly seen in the short bones such as metacarpals, metatarsals and phalanges. The infection starts insidiously in the diaphysis with a fusiform painful swelling that may clinically resemble some of the inflammatory arthropathies so there may be diagnostic confusion. Multifocal TB dactylitis may be seen in debilitated children.