{"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":"patologia-de-la-tuberculosis-cutanea","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/pt\/wiki\/patologia-de-la-tuberculosis-cutanea\/","title":{"rendered":"Patologia da tuberculose cut\u00e2nea."},"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\">Conte\u00fado<\/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=\"Alternar tabela de conte\u00fado\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Alternar<\/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\/pt\/wiki\/patologia-de-la-tuberculosis-cutanea\/#Histologia-de-tuberculosis-cutanea\" >Histolog\u00eda de tuberculosis cut\u00e1nea<\/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\/pt\/wiki\/patologia-de-la-tuberculosis-cutanea\/#Patologia-de-la-tuberculosis-cutanea\" >Patologia da tuberculose cut\u00e2nea.<\/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\/pt\/wiki\/patologia-de-la-tuberculosis-cutanea\/#Estudios-especiales-para-tuberculosis-cutanea\" >Estudios especiales para tuberculosis cut\u00e1nea.<\/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\/pt\/wiki\/patologia-de-la-tuberculosis-cutanea\/#Diagnostico-diferencial-de-tuberculosis-cutanea-patologia\" >Diagn\u00f3stico diferencial de tuberculosis cut\u00e1nea patolog\u00eda<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<p><span class=\"term\" data-term-id=\"47\">Cut\u00e2neo<\/span> la tuberculosis es causada por <span class=\"term\" data-term-id=\"145\">infec\u00e7\u00e3o<\/span> por Mycobacterium tuberculosis. Ha habido varios m\u00e9todos para clasificar la infecci\u00f3n. Tradicionalmente, la infecci\u00f3n se ha dividido en <span class=\"term\" data-term-id=\"949\">prim\u00e1rio<\/span> infecci\u00f3n, donde no ha habido exposici\u00f3n previa a la <span class=\"term\" data-term-id=\"882\">organismo<\/span>y tuberculosis secundaria, resultante de la reinfecci\u00f3n.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"Histologia-de-tuberculosis-cutanea\"><\/span>\n<span class=\"term\" data-term-id=\"128\">Histologia<\/span> de tuberculosis cut\u00e1nea<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Prim\u00e1rio <span class=\"term\" data-term-id=\"1870\">inocula\u00e7\u00e3o<\/span> con bacilos tuberculosos puede comenzar con la superficie <span class=\"term\" data-term-id=\"1278\">ulcera\u00e7\u00e3o<\/span>, <span class=\"term\" data-term-id=\"846\">epid\u00e9rmico<\/span> <span class=\"term\" data-term-id=\"136\">hiperplasia<\/span> y un denso <span class=\"term\" data-term-id=\"52\">d\u00e9rmico<\/span> <span class=\"term\" data-term-id=\"541\">infiltrar<\/span> Rico en <span class=\"term\" data-term-id=\"196\"><span class=\"term\" data-term-id=\"442\">neutr\u00f3filos<\/span><\/span>  (Figura 1). <span class=\"term\" data-term-id=\"67\">Disseminado<\/span> la tuberculosis cut\u00e1nea y la tuberculosis orificial t\u00edpicamente mostrar\u00e1n una similar <span class=\"term\" data-term-id=\"443\">neutrof\u00edlico<\/span> reacci\u00f3n en lesiones tempranas. Con el tiempo, los neutr\u00f3filos son reemplazados por <span class=\"term\" data-term-id=\"319\">cr\u00f4nica<\/span> <span class=\"term\" data-term-id=\"490\">inflamat\u00f3rio<\/span> c\u00e9lulas y necrotizantes <span class=\"term\" data-term-id=\"1076\">granulomatoso<\/span> <span class=\"term\" data-term-id=\"148\">inflama\u00e7\u00e3o<\/span> rodeado de numerosos <span class=\"term\" data-term-id=\"421\">linf\u00f3citos<\/span> si el paciente tiene un sistema inmunitario competente (como se ve con el subtipo cl\u00ednico tuberculosis vurrucosa). Las Figuras 2,3,4 muestran la misma imagen de la caracter\u00edstica inflamaci\u00f3n granulomatosa necrotizante rodeada por un <span class=\"term\" data-term-id=\"422\">linfoc\u00edtico<\/span> respuesta a aumentos progresivamente m\u00e1s altos. Tub\u00e9rculo <span class=\"term\" data-term-id=\"883\">organismos<\/span> son generalmente f\u00e1ciles de encontrar al principio <span class=\"term\" data-term-id=\"901\">supurativo<\/span> lesiones y dif\u00edciles de identificar cuando la inflamaci\u00f3n granulomatosa se ha desarrollado bien.<\/p>\n<p>El lupus vulgar es el tipo cl\u00ednico m\u00e1s com\u00fan de reinfecci\u00f3n de tuberculosis cut\u00e1nea y muestra una buena formaci\u00f3n <span class=\"term\" data-term-id=\"1718\">granulomas<\/span> rodeado de c\u00e9lulas inflamatorias cr\u00f3nicas, y central <span class=\"term\" data-term-id=\"403\">necrose<\/span> (Figuras 2-4). La necrosis suele ser menos pronunciada que el ejemplo ilustrado aqu\u00ed.<\/p>\n<p>El escrofuloderma mostrar\u00e1 una imagen histol\u00f3gica similar a la observada en las figuras-2,4, pero a menudo hay ulceraci\u00f3n y supuraci\u00f3n superficial, as\u00ed como la infecci\u00f3n. <span class=\"term\" data-term-id=\"1775\">g\u00e2nglios linf\u00e1ticos<\/span> conectarse a trav\u00e9s de <span class=\"term\" data-term-id=\"267\">seio<\/span> Tractos con la piel suprayacente.<\/p>\n<section class=\"textBlock imageLinkBlockTitle\">\n<h5 class=\"colour--primary\"><span class=\"ez-toc-section\" id=\"Patologia-de-la-tuberculosis-cutanea\"><\/span>Patologia da tuberculose cut\u00e2nea.<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='tuberculosis-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\">figura 1<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='tuberculosis-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\">Figura 2<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='tuberculosis-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\">Figura 3<\/p>\n<div class=\"imageLinkBlock__item__image\">\n<p>                        <img alt='tuberculosis-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\">Figura 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>Estudios especiales para tuberculosis cut\u00e1nea.<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Los organismos pueden demostrarse en la tuberculosis cut\u00e1nea con Ziehl-Neelen \/ tinci\u00f3n \u00e1cido-r\u00e1pida, pero pueden ser extremadamente dif\u00edciles de encontrar y ausentes en muchos casos, particularmente cuando la respuesta granulomatosa est\u00e1 bien establecida. <span class=\"term\" data-term-id=\"837\">Cultura<\/span> Los estudios a veces son \u00fatiles, pero pueden tardar meses en completarse. <span class=\"term\" data-term-id=\"941\">Rea\u00e7\u00e3o em cadeia da polimerase<\/span> (<span class=\"term\" data-term-id=\"942\">PCR<\/span>) puede permitir un an\u00e1lisis r\u00e1pido, pero puede no ser muy sensible en formas paucibacilares de tuberculosis cut\u00e1nea.<\/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\">Diagn\u00f3stico diferencial<\/span> de tuberculosis cut\u00e1nea <span class=\"term\" data-term-id=\"223\">patologia<\/span><br \/>\n<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>S\u00edfilis granulomatosa, infecci\u00f3n f\u00fangica profunda, leishmaniasis &#8211; PCR y estudios de cultivo pueden ser necesarios para la distinci\u00f3n en casos dif\u00edciles.<\/p>\n<p>Lepra tuberculoide &#8211; Neural <span class=\"term\" data-term-id=\"543\">infiltra\u00e7\u00e3o<\/span> y menos necrosis son pistas para este diagn\u00f3stico. <span class=\"term\" data-term-id=\"1513\">Plasma<\/span> Se dice que las c\u00e9lulas son m\u00e1s comunes en la lepra. PCR o estudios de cultivo pueden ser necesarios para esta distinci\u00f3n.<\/p>\n<p>Sarcoidose: geralmente carece <span class=\"term\" data-term-id=\"1567\">necrose caseante<\/span> mas pode mostrar algo <span class=\"term\" data-term-id=\"1424\">fibrin\u00f3ide<\/span> Degeneraci\u00f3n dentro de los granulomas que puede causar confusi\u00f3n. El sarcoide generalmente carece de la respuesta linfoc\u00edtica que a menudo se observa en la tuberculosis (figuras 1, 2). La PCR y los estudios de cultivo pueden ser \u00fatiles.<\/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\/pt\/wp-json\/wp\/v2\/wiki\/6653","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/comments?post=6653"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/wiki\/6653\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/media?parent=6653"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/categories?post=6653"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/pt\/wp-json\/wp\/v2\/tags?post=6653"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}