{"id":6653,"date":"2020-04-22T14:57:20","date_gmt":"2020-04-22T17:57:20","guid":{"rendered":"https:\/\/doctorhoogstra.com\/es\/patologia-de-la-tuberculosis-cutanea\/"},"modified":"2020-05-03T18:25:06","modified_gmt":"2020-05-03T21:25:06","slug":"pathologie-de-la-tuberculose-cutanee","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/fr\/wiki\/patologia-de-la-tuberculosis-cutanea\/","title":{"rendered":"Pathologie de la tuberculose cutan\u00e9e."},"content":{"rendered":"<p><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_87_1 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Contenu<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Basculer la table des mati\u00e8res\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Basculer<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/doctorhoogstra.com\/fr\/wiki\/patologia-de-la-tuberculosis-cutanea\/#Histologia-de-tuberculosis-cutanea\" >Histologie de la tuberculose cutan\u00e9e<\/a><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><ul class='ez-toc-list-level-5' ><li class='ez-toc-heading-level-5'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/doctorhoogstra.com\/fr\/wiki\/patologia-de-la-tuberculosis-cutanea\/#Patologia-de-la-tuberculosis-cutanea\" >Pathologie de la tuberculose cutan\u00e9e.<\/a><\/li><\/ul><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/doctorhoogstra.com\/fr\/wiki\/patologia-de-la-tuberculosis-cutanea\/#Estudios-especiales-para-tuberculosis-cutanea\" >\u00c9tudes sp\u00e9ciales pour la tuberculose cutan\u00e9e.<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/doctorhoogstra.com\/fr\/wiki\/patologia-de-la-tuberculosis-cutanea\/#Diagnostico-diferencial-de-tuberculosis-cutanea-patologia\" >Diagnostic diff\u00e9rentiel de la pathologie cutan\u00e9e de la tuberculose<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<p><span class=\"term\" data-term-id=\"47\">Cutan\u00e9<\/span> la tuberculose est caus\u00e9e par <span class=\"term\" data-term-id=\"145\">infection<\/span> par Mycobacterium tuberculosis. Il existe plusieurs m\u00e9thodes pour classer l&#039;infection. Traditionnellement, l&#039;infection a \u00e9t\u00e9 divis\u00e9e en <span class=\"term\" data-term-id=\"949\">primaire<\/span> infection, o\u00f9 il n&#039;y a pas eu d&#039;exposition ant\u00e9rieure \u00e0 <span class=\"term\" data-term-id=\"882\">organisme<\/span>et la tuberculose secondaire, r\u00e9sultant d&#039;une r\u00e9infection.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Histologia-de-tuberculosis-cutanea\"><\/span>\n<span class=\"term\" data-term-id=\"128\">Histologie<\/span> de la tuberculose cutan\u00e9e<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Primaire <span class=\"term\" data-term-id=\"1870\">inoculation<\/span> avec des bacilles tuberculeux peut commencer par la surface <span class=\"term\" data-term-id=\"1278\">ulc\u00e9ration<\/span>, <span class=\"term\" data-term-id=\"846\">\u00e9pidermique<\/span> <span class=\"term\" data-term-id=\"136\">hyperplasie<\/span> et une dense <span class=\"term\" data-term-id=\"52\">dermique<\/span> <span class=\"term\" data-term-id=\"541\">infiltrer<\/span> riche en <span class=\"term\" data-term-id=\"196\"><span class=\"term\" data-term-id=\"442\">neutrophiles<\/span><\/span>  (Figure 1). <span class=\"term\" data-term-id=\"67\">Diffus\u00e9<\/span> la tuberculose cutan\u00e9e et la tuberculose orificielle montreront g\u00e9n\u00e9ralement un <span class=\"term\" data-term-id=\"443\">neutrophile<\/span> r\u00e9action aux blessures pr\u00e9coces. Au fil du temps, les neutrophiles sont remplac\u00e9s par <span class=\"term\" data-term-id=\"319\">chronique<\/span> <span class=\"term\" data-term-id=\"490\">inflammatoire<\/span> cellules et n\u00e9crosantes <span class=\"term\" data-term-id=\"1076\">granulomateux<\/span> <span class=\"term\" data-term-id=\"148\">inflammation<\/span> entour\u00e9 de nombreux <span class=\"term\" data-term-id=\"421\">lymphocytes<\/span> si le patient a un syst\u00e8me immunitaire comp\u00e9tent (comme on le voit avec le sous-type clinique tuberculosis vurrucosa). Les figures 2,3,4 montrent la m\u00eame image de l&#039;inflammation granulomateuse n\u00e9crosante caract\u00e9ristique entour\u00e9e d&#039;un <span class=\"term\" data-term-id=\"422\">lymphocytaire<\/span> r\u00e9ponse \u00e0 des augmentations progressivement plus \u00e9lev\u00e9es. Tubercule <span class=\"term\" data-term-id=\"883\">organismes<\/span> sont g\u00e9n\u00e9ralement faciles \u00e0 trouver au d\u00e9but <span class=\"term\" data-term-id=\"901\">suppuratif<\/span> l\u00e9sions et difficile \u00e0 identifier lorsque l&#039;inflammation granulomateuse s&#039;est bien d\u00e9velopp\u00e9e.<\/p>\n<p>Le lupus vulgaris est le type clinique le plus courant de r\u00e9infection cutan\u00e9e par la tuberculose et montre une bonne formation <span class=\"term\" data-term-id=\"1718\">granulomes<\/span> entour\u00e9e de cellules inflammatoires chroniques et centrale <span class=\"term\" data-term-id=\"403\">n\u00e9crose<\/span> (Figures 2-4). La n\u00e9crose est g\u00e9n\u00e9ralement moins prononc\u00e9e que dans l&#039;exemple illustr\u00e9 ici.<\/p>\n<p>La scrofulodermie montrera une image histologique similaire \u00e0 celle des figures 2, 4, mais il y a souvent une ulc\u00e9ration et une suppuration superficielles ainsi qu&#039;une infection. <span class=\"term\" data-term-id=\"1775\">ganglions lymphatiques<\/span> se connecter via <span class=\"term\" data-term-id=\"267\">Sein<\/span> Tracts avec la peau sus-jacente.<\/p>\n<section class=\"textBlock imageLinkBlockTitle\">\n<h5 class=\"colour--primary\"><span class=\"ez-toc-section\" id=\"Patologia-de-la-tuberculosis-cutanea\"><\/span>Pathologie de la tuberculose cutan\u00e9e.<span class=\"ez-toc-section-end\"><\/span><\/h5>\n<\/section>\n<section class=\"imageLinkBlock\">\n<div class=\"flex\">\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='tuberculose-fig-1__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-1172642-1575786' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/tuberculosis-fig-1__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-1172642.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 1<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='tuberculose-fig-2__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-3318385-9229267' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/tuberculosis-fig-2__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-3318385.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 2<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='tuberculose-fig-3__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-1797475-1729618' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/tuberculosis-fig-3__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-1797475.jpg'>\n<\/div>\n<p class=\"p-small\">figure 3<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='tuberculose-fig-4__protectwyjqcm90zwn0il0_focusfillwzi5ncwymjisingildfd-8311657-5503325' src='https:\/\/doctorhoogstra.com\/wp-content\/uploads\/2020\/04\/tuberculosis-fig-4__ProtectWyJQcm90ZWN0Il0_FocusFillWzI5NCwyMjIsIngiLDFd-8311657.jpg'>\n<\/div>\n<p class=\"p-small\">Figure 4<\/p>\n<\/p><\/div>\n<\/section>\n<div class=\"clearfix imageLinkBlock\"><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Estudios-especiales-para-tuberculosis-cutanea\"><\/span>\u00c9tudes sp\u00e9ciales pour la tuberculose cutan\u00e9e.<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Les organismes peuvent \u00eatre mis en \u00e9vidence dans la tuberculose cutan\u00e9e avec une coloration de Ziehl-Neelen\/acide-r\u00e9sistant, mais peuvent \u00eatre extr\u00eamement difficiles \u00e0 trouver et absents dans de nombreux cas, en particulier lorsque la r\u00e9ponse granulomateuse est bien \u00e9tablie. <span class=\"term\" data-term-id=\"837\">Culture<\/span> Les \u00e9tudes sont parfois utiles, mais peuvent prendre des mois. <span class=\"term\" data-term-id=\"941\">R\u00e9action en cha\u00eene par polym\u00e9rase<\/span> (<span class=\"term\" data-term-id=\"942\">PCR<\/span>) peut permettre une analyse rapide, mais peut \u00eatre peu sensible dans les formes paucibacillaires de tuberculose cutan\u00e9e.<\/p>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"Diagnostico-diferencial-de-tuberculosis-cutanea-patologia\"><\/span>\n<span class=\"term\" data-term-id=\"813\">Diagnostic diff\u00e9rentiel<\/span> de la tuberculose cutan\u00e9e <span class=\"term\" data-term-id=\"223\">pathologie<\/span><br \/>\n<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Syphilis granulomateuse, infection fongique profonde, leishmaniose - Des \u00e9tudes PCR et de culture peuvent \u00eatre n\u00e9cessaires pour la distinction dans les cas difficiles.<\/p>\n<p>L\u00e8pre tuberculo\u00efde - Neural <span class=\"term\" data-term-id=\"543\">infiltration<\/span> et moins de n\u00e9crose sont des indices de ce diagnostic. <span class=\"term\" data-term-id=\"1513\">Plasma<\/span> Les cellules seraient plus fr\u00e9quentes dans la l\u00e8pre. Des \u00e9tudes PCR ou de culture peuvent \u00eatre n\u00e9cessaires pour cette distinction.<\/p>\n<p>Sarco\u00efdose : manque g\u00e9n\u00e9ralement <span class=\"term\" data-term-id=\"1567\">n\u00e9crose cas\u00e9euse<\/span> mais tu peux montrer quelque chose <span class=\"term\" data-term-id=\"1424\">fibrino\u00efde<\/span> D\u00e9g\u00e9n\u00e9rescence au sein des granulomes pouvant entra\u00eener une confusion. Le sarco\u00efde est g\u00e9n\u00e9ralement d\u00e9pourvu de la r\u00e9ponse lymphocytaire souvent observ\u00e9e dans la tuberculose (figures 1, 2). Des \u00e9tudes de PCR et de culture peuvent \u00eatre utiles.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>Cut\u00e1neo la tuberculosis es causada por infecci\u00f3n por Mycobacterium tuberculosis. Ha habido varios m\u00e9todos para clasificar la infecci\u00f3n. Tradicionalmente, la infecci\u00f3n se ha dividido en primario infecci\u00f3n, donde no ha&#8230;<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[205],"class_list":["post-6653","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones","tag-patologia"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/wiki\/6653","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/comments?post=6653"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/wiki\/6653\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/media?parent=6653"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/categories?post=6653"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/fr\/wp-json\/wp\/v2\/tags?post=6653"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}