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1.
Tokai J Exp Clin Med ; 45(3): 136-138, 2020 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-32901902

RESUMO

In recent years, BCG vaccination is routinely performed worldwide. The Ministry of Health, Labor and Welfare of Japan reported that the vaccination rate was as high as 92.9% in 2011. Majority of the reported local adverse reactions to BCG vaccination included lymph node swelling, keloid formation, and abscesses. Subcutaneous tuberculous granuloma is a rare local adverse reaction to BCG vaccination. Herein, we report two cases of developing subcutaneous tuberculous granuloma associated with BCG vaccination. Both of them were treated with isoniazid. There is no standard management for BCG-induced subcutaneous tuberculous granuloma, however, treatment with anti-tuberculosis drugs should be considered for cases of BCGinduced subcutaneous tuberculous granuloma with abscesses or ulcerations.


Assuntos
Vacina BCG/efeitos adversos , Granuloma/etiologia , Dermatopatias/etiologia , Tuberculose Cutânea/etiologia , Antituberculosos/uso terapêutico , Feminino , Granuloma/tratamento farmacológico , Humanos , Lactente , Isoniazida/uso terapêutico , Masculino , Resultado do Tratamento , Tuberculose Cutânea/tratamento farmacológico
2.
Medicine (Baltimore) ; 99(27): e21112, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629745

RESUMO

RATIONALE: Lupus miliaris disseminatus faciei (LMDF) is an inflammatory granulomatous skin disease without a clear etiology that frequently involves the middle area of the face and the upper eyelids. Pathological features of the disease include caseation necrosis and epithelioid granuloma. Consensus treatment for LMDF is currently unavailable. PATIENT CONCERNS: A 47-year-old Chinese female patient who presented with facial pruritic, erythematous papules 8 months before this study. She was diagnosed with skin tuberculosis at another hospital and given antituberculosis medication. However, the treatment was not efficacious. DIAGNOSES: In this study, the diagnosis of Demodex-induced LMDF was made by a dermatologist according to physical examination, skin biopsy pathology, and microscopic examination. INTERVENTIONS: The patient was given ornidazole tablets (500 mg twice a day) and recombinant bovine basic fibroblast growth factor gel (0.2 g/cm twice a day) for an 8-week period. OUTCOMES: Eight weeks after the treatment, the facial erythematous papules were improved, and no new skin lesions were observed. The patient showed no signs of recurrence during the 6-month follow-up. LESSONS SUBSECTIONS: This case showed that ornidazole combined with recombinant bovine basic fibroblast growth factor gel might be useful in treatment of Demodex-induced LMDF. In addition, the results suggested that pathological caseation necrosis was caused by a series of inflammatory and immune responses to Demodex infection.


Assuntos
Dermatoses Faciais/etiologia , Rosácea/parasitologia , Pele/parasitologia , Amebicidas/administração & dosagem , Amebicidas/uso terapêutico , Animais , Grupo com Ancestrais do Continente Asiático/etnologia , Erros de Diagnóstico , Dermatoses Faciais/patologia , Feminino , Fatores de Crescimento de Fibroblastos/administração & dosagem , Fatores de Crescimento de Fibroblastos/uso terapêutico , Granuloma/patologia , Humanos , Pessoa de Meia-Idade , Ácaros/parasitologia , Necrose/patologia , Ornidazol/administração & dosagem , Ornidazol/uso terapêutico , Rosácea/tratamento farmacológico , Pele/patologia , Pele/ultraestrutura , Resultado do Tratamento , Tuberculose Cutânea/diagnóstico , Tuberculose Cutânea/tratamento farmacológico
4.
An Bras Dermatol ; 95(3): 343-346, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32303434

RESUMO

Cutaneous tuberculosis is a rare extrapulmonary manifestation of tuberculosis which, like disseminated tuberculosis, commonly occurs in immunocompromised patients. Poncet reactive arthritis is a seronegative arthritis affecting patients with extrapulmonary tuberculosis, which is uncommon even in endemic countries. We report a previously healthy 23-year-old male patient with watery diarrhea associated with erythematous ulcers on the lower limbs and oligoarthritis of the hands. Histopathological examination of the skin showed epithelioid granulomatous process with palisade granulomas and central caseous necrosis. AFB screening by Ziehl-Neelsen staining showed intact bacilli, the culture was positive for Mycobacterium tuberculosis, and colonoscopy revealed multiple shallow ulcers. Disseminated tuberculosis associated with reactive Poncet arthritis was diagnosed, with an improvement of the clinical and skin condition after appropriate treatment.


Assuntos
Artrite Reativa/imunologia , Imunocompetência , Hospedeiro Imunocomprometido , Tuberculose Cutânea/imunologia , Tuberculose Cutânea/patologia , Antituberculosos/uso terapêutico , Etambutol/uso terapêutico , Humanos , Isoniazida/uso terapêutico , Masculino , Mycobacterium tuberculosis/isolamento & purificação , Pirazinamida/uso terapêutico , Rifampina/uso terapêutico , Úlcera Cutânea/tratamento farmacológico , Úlcera Cutânea/imunologia , Úlcera Cutânea/patologia , Resultado do Tratamento , Tuberculose Cutânea/tratamento farmacológico , Adulto Jovem
5.
Int J Nanomedicine ; 15: 1073-1094, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32103956

RESUMO

Purpose: This study demonstrated improved transdermal delivery of rifampicin-loaded cationic nanoemulsion gel to treat systemic and cutaneous tuberculosis using capmul, labrasol, and acconon, which exert anti-Mycobacterium activities. This approach enhanced drug permeation across the skin, increased therapeutic efficacy, and reduced dose-related side effects. Methods: Design Expert® was used to optimize formulations (Smix ratio and capmul as independent factors), which were prepared using a slow spontaneous titration method. The optimized nanoemulsion was incorporated into carbopol gel to allow for topical application and comparative assessments. Nanoemulsions and gels were evaluated for size, size distribution, shape, zeta potential, percent spread, viscosity, in vitro hemolysis, in vitro release, and ex vivo skin permeation and deposition. A mechanistic evaluation was performed using scanning electron microscopy. Furthermore, in vivo pharmacokinetic and irritation studies were performed. Results: The optimized cationic nanoemulsion (OCNE-1) was characterized by small particle size (≤100 nm), had optimal viscosity, percent spread, zeta potential, and percent drug release, and was hemocompatible. The OCNE-1T gel exhibited higher permeation flux (51.32 ± 0.5 µg/cm2 hr), permeation coefficient (2.566 ± 0.08 cm/hr), drug deposition (994.404 µg/cm2), and enhancement ratio (7.16) than those of the OCNE-1 nanoemulsion or drug solution. Scanning electron microscopy was used to characterize the mechanism of enhanced permeation. An In vivo study showed that the Cmax and area under the curve following transdermal application were 4.34- and 4.74-fold higher than those following oral administration. Conclusion: Transdermal delivery of rifampicin could be a promising alternative to conventional approaches to treat systemic and local tuberculosis, and other bacterial infections.


Assuntos
Antituberculosos/administração & dosagem , Emulsões/administração & dosagem , Rifampina/administração & dosagem , Tuberculose/tratamento farmacológico , Resinas Acrílicas/química , Administração Cutânea , Animais , Antituberculosos/farmacocinética , Antituberculosos/farmacologia , Disponibilidade Biológica , Caprilatos/química , Cátions/química , Emulsões/farmacologia , Excipientes/química , Géis/química , Géis/farmacologia , Glicerídeos/química , Mycobacterium/efeitos dos fármacos , Nanoestruturas/administração & dosagem , Nanoestruturas/química , Tamanho da Partícula , Ratos Sprague-Dawley , Rifampina/farmacocinética , Rifampina/farmacologia , Pele/efeitos dos fármacos , Tuberculose Cutânea/tratamento farmacológico
7.
Int J Dermatol ; 58(12): 1451-1459, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31553059

RESUMO

BACKGROUND: Brazil is one of the highest tuberculosis (TB) burden countries of the world. Cutaneous tuberculosis (CTB) is a rare form of extrapulmonary manifestation of tuberculosis. This study aimed to describe the clinico-evolutive, laboratory and therapeutic aspects of CTB cases among patients from a cohort with TB in Rio de Janeiro, Brazil. METHODS: Cases of diagnosed CTB with microbiologic confirmation or clinical response to anti-tuberculous treatment associated with positive smear or histopathological findings between the years 2000 and 2016 were selected. RESULTS: Seventy-five patients with CTB were included, most were women (58.7%) with a median age of 42 years. CTB diagnosis was based on culture in only 42.7% of the cases. Scrofuloderma represented 50.7% of the cases, followed by erythema induratum of Bazin (EIB) (18.7%), tuberculous gumma (13.3%), lupus vulgaris (8%), TB verrucosa cutis (4%), orificial TB (2.7%) and associated forms (2.7%). Other TB presentations were pulmonary (22.7%), mammary (6.6%) and osteoarticular (4%). All patients who completed the treatment (97.3%) had their lesions healed. Only two patients (2.6%) needed to change the therapy due to adverse reactions. Fifty percent of EIB patients presented recurrence. CONCLUSIONS: These data highlight the diversity of CTB presentations and the importance of the skin to assist in early identification and treatment of TB. More studies are necessary to improve the knowledge on EIB for a better approach towards these patients, mainly in cases of recurrence.


Assuntos
Antituberculosos/uso terapêutico , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose Cutânea/epidemiologia , Tuberculose Osteoarticular/epidemiologia , Tuberculose Pulmonar/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Pele/microbiologia , Pele/patologia , Resultado do Tratamento , Tuberculose Cutânea/tratamento farmacológico , Tuberculose Cutânea/microbiologia , Tuberculose Cutânea/patologia , Tuberculose Osteoarticular/tratamento farmacológico , Tuberculose Osteoarticular/microbiologia , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/microbiologia , Adulto Jovem
9.
Med Sante Trop ; 29(2): 139-141, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31379337

RESUMO

Cutaneous tuberculosis with lymphatic spread is rarely described. We report the case of a woman aged 38, immunocompetent, working in a fruit sorting center, who consulted us for ulceration of the left third finger that had persisted for four months, following a prick from a prickly pear. Physical examination revealed a nodular, erythematous, and ulcerative lesion of the left third finger, associated with inflammatory subcutaneous nodules arranged in a line along the ipsilateral upper extremity and an ipsilateral axillary lymph node. Laboratory tests and chest X-ray were normal. Pathological examination revealed granulomatous chronic inflammation without necrosis. PCR detected DNA from Mycobacterium tuberculosis. No extracutaneous tuberculosis locations were detected. A tuberculous chancre by direct inoculation was therefore diagnosed. The patient received quadruple therapy (rifampicin + isoniazid + pyrazinamide + ethambutol) for 2 months, followed by a combination therapy based on isoniazid and rifampicin for 6 months. Marked regression of the cutaneous lesions occurred after 1 month of first-line therapy. A tuberculous chancre is a rare form of cutaneous tuberculosis, with possible lymphatic spread, in immunocompromised patients but also in immunocompetent children and young adults.


Assuntos
Tuberculose Cutânea/complicações , Tuberculose dos Linfonodos/etiologia , Adulto , Feminino , Humanos , Imunocompetência , Tuberculose Cutânea/diagnóstico , Tuberculose Cutânea/tratamento farmacológico , Tuberculose dos Linfonodos/diagnóstico , Tuberculose dos Linfonodos/tratamento farmacológico
10.
Acta Derm Venereol ; 99(11): 997-1003, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31396633

RESUMO

To identify the microorganism distribution clinical characteristics and management of cutaneous Mycobacterium tuberculosis and nontuberculous mycobacterial infectious diseases in the past 10 years we collected and analyzed the patient records of all cutaneous M. tuberculosis and nontuberculous mycobacterial infection cases diagnosed by culture and/or PCR from 2008 to 2017 in the Hospital of Dermatology Chinese Academy of Medical Sciences. Among 203 cases including 89 M. tuberculosis infections and 114 nontuberculous mycobacterial infections M. tuberculosis was the most common species in all patients and M. marinum predominated among the nontuberculous mycobacterial followed by M. abscessus. Cases of cutaneous mycobacterial infection especially nontuberculous mycobacterial infection increased in the past 10 years and infection with rapidly growing mycobacteria significantly increased in the last 5 years in this national hospital in Southeast China. Injuries were common causative factors. Approximately 91.3% of patients responded well to longstanding antibiotic therapy.


Assuntos
Hospitais Especializados , Infecções por Mycobacterium não Tuberculosas/microbiologia , Mycobacterium tuberculosis/crescimento & desenvolvimento , Micobactérias não Tuberculosas/crescimento & desenvolvimento , Dermatopatias Bacterianas/microbiologia , Tuberculose Cutânea/microbiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Antituberculosos/uso terapêutico , Criança , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Infecções por Mycobacterium não Tuberculosas/epidemiologia , Mycobacterium tuberculosis/efeitos dos fármacos , Mycobacterium tuberculosis/genética , Micobactérias não Tuberculosas/efeitos dos fármacos , Micobactérias não Tuberculosas/genética , Dermatopatias Bacterianas/diagnóstico , Dermatopatias Bacterianas/tratamento farmacológico , Dermatopatias Bacterianas/epidemiologia , Fatores de Tempo , Resultado do Tratamento , Tuberculose Cutânea/diagnóstico , Tuberculose Cutânea/tratamento farmacológico , Tuberculose Cutânea/epidemiologia , Adulto Jovem
11.
Int J Mycobacteriol ; 8(2): 202-204, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31210168

RESUMO

Elephantiasis nostras verrucosa is used to describe lymphedema of the lower limbs caused by a nonfilarial etiology. Infective etiologies include bacterial and fungal infections along with chronic venous stasis, postirradiation, congestive heart failure, obesity, and malignancies, all causes leading to lymphatic obstruction and edema. We herein describe a case of a 70-year-old male who presented with diffuse nonpitting edema of the entire left lower limb with cobblestoning of the surface with a positive Kaposi-Stemmer sign and presence of a verrucous plaque over the left ankle. Histopathology of the verrucous plaque revealed it to be tuberculosis verrucosa cutis (TVC). We report this rare presentation of TVC as a cause of unilateral lymphedema.


Assuntos
Elefantíase/microbiologia , Extremidade Inferior/microbiologia , Tuberculose Cutânea/diagnóstico , Idoso , Antituberculosos/uso terapêutico , Humanos , Extremidade Inferior/patologia , Masculino , Resultado do Tratamento , Tuberculose Cutânea/complicações , Tuberculose Cutânea/tratamento farmacológico
12.
Clin Dermatol ; 37(3): 192-199, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31178102

RESUMO

Tuberculosis (TB) is still prevalent in many developing countries and can pose a new potential threat to global health due to international migration. As an uncommon form of extrapulmonary TB, cutaneous TB is complicated in its clinical manifestation, pathogenesis, and classification. Cutaneous TB can be divided into two major categories, true cutaneous TB and tuberculid, depending on the source of infection, the route of transmission, the amount of bacteria, and the immune state of the host. Clinical manifestations may include patches and plaques (lupus vulgaris, TB verrucosa cutis), macules and papules (acute miliary TB, papulonecrotid tuberculid, lichen scrofulosorum), nodules, and abscesses (erythema induratum of Bazin, tuberculous gumma), erosions, and ulcers (tuberculous chancre, orificial TB, scrofuloderma), mimicking diverse skin diseases. Uncommon localizations such as external genitalia, unusual presentations such as nodular granulomatous phlebitis, and coexistence with other morbidities such as Behçet disease and acne inversa or hidradenitis suppurativa deserve special attention. Treatment of both true and tuberculid cutaneous TB follows the same drug regimens of the World Health Organization's recommendation for treatment of new cases of pulmonary TB. Erythema induratum of Bazin may need longer treatment duration and adjuvants such as dapsone, potassium iodide, doxycycline, and corticosteroids to tackle inflammation. Misdiagnosis and undertreatment in daily practice are likely, and contemplation of this classic great imitator in dermatology is warranted.


Assuntos
Tuberculose Cutânea/diagnóstico , Tuberculose Cutânea/tratamento farmacológico , Adolescente , Corticosteroides/administração & dosagem , Adulto , Antituberculosos/uso terapêutico , Criança , Dapsona/administração & dosagem , Diagnóstico Diferencial , Erros de Diagnóstico , Doxiciclina/administração & dosagem , Quimioterapia Combinada , Feminino , Infecções por HIV , Humanos , Masculino , Mycobacterium tuberculosis/isolamento & purificação , Iodeto de Potássio/administração & dosagem , Pele/microbiologia , Pele/patologia , Tuberculose Cutânea/microbiologia , Tuberculose Cutânea/patologia , Adulto Jovem
13.
Acta Med Port ; 32(4): 313-316, 2019 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-31067426

RESUMO

The incidence of tuberculosis has been increasing worldwide. Contrarily, a recent decrease in Portugal has been reported. Cutaneous tuberculosis comprises a low percentage of all cases. We report a 70-year-old female with a 2-month-history of painful, nodular, suppurative lesions in the groin area, bilaterally. Previous history was remarkable for Human Immunodeficiency Virus infection and stage-IIIB cervical cancer. A skin biopsy, stained with periodic acid-Schiff and Fite's stain, polymerase chain reaction on purulent discharge and mycobacterial culture of the skin were performed, leading to the diagnosis of scrofuloderma. Tuberculostatic therapy was initiated and complete response was observed. This case depicts an uncommon variant of tuberculosis, highlighting the need for awareness of the cutaneous variants of tuberculosis that, although rare, can still present in the clinic today.


Assuntos
Tuberculose Cutânea/diagnóstico , Idoso , Conscientização , Biópsia , Feminino , Virilha , Soropositividade para HIV/diagnóstico , Humanos , Portugal , Pele/patologia , Tuberculose Cutânea/tratamento farmacológico , Tuberculose Cutânea/patologia
15.
Cutis ; 103(2): E32-E35, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30893397

RESUMO

Cutaneous gummatous tuberculosis (TB) is an uncommon subtype of cutaneous TB that can be seen in notably immunocompromised individuals. We report a case of cutaneous gummatous TB in an immunosuppressed kidney transplant patient. A 60-year-old Cambodian woman presented with fever attributed to recurrent pyelonephritis while on immunosuppressive medications 7 months after kidney transplant. She underwent a bilateral native nephrectomy and was found to have peritoneal nodules, which revealed caseating granulomas and acid-fast bacilli (AFB) consistent with kidney and peritoneal TB. Anti-TB therapy was initiated, resulting in symptom resolution. Subsequently, the Tuberculosis Control Program at the Department of Health (Philadelphia, Pennsylvania) discontinued her medications due to severe thrombocytopenia. During this time, she was closely monitored with blood draws. Approximately 10 weeks after treatment initiation, she noted recurrent fever and a painful, dull red, subcutaneous nodule on the right side of the flank. Biopsy showed an inflammatory infiltrate within the deep dermis indicative of suppurative granulomatous dermatitis. Ziehl-Neelsen stain demonstrated rare AFB within the cytoplasm of macrophages. The patient was restarted on anti-TB therapy resulting in the resolution of her fever and skin lesions. This case illustrates a noteworthy example of a rare form of cutaneous gummatous TB, which should be considered and included in the differential for cutaneous lesions in an immunosuppressed patient.


Assuntos
Antituberculosos/administração & dosagem , Hospedeiro Imunocomprometido , Transplante de Rim , Tuberculose Cutânea/diagnóstico , Feminino , Granuloma/diagnóstico , Granuloma/microbiologia , Humanos , Imunossupressores/administração & dosagem , Pessoa de Meia-Idade , Tuberculose Cutânea/tratamento farmacológico
18.
J Med Case Rep ; 12(1): 371, 2018 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-30554566

RESUMO

BACKGROUND: Cutaneous tuberculosis represents only 1-2% of extrapulmonary forms of tuberculosis. Scrofuloderma is an endogenous form of cutaneous tuberculosis and can present as isolated or coexist with pulmonary and disseminated forms of tuberculosis. Pathologically confirmed scrofuloderma coexisting with disseminated tuberculosis with a good treatment response is presented and discussed. CASE PRESENTATION: A 12-year-old African Ethiopian girl presented with bilateral neck swelling with purulent discharge and skin ulceration of 3 months' duration. Dry cough, low-grade fever, decreased appetite, drenching night sweats, global throbbing headache, and a significant amount of weight loss were also reported. Biopsy of the skin identified scrofuloderma, and Mycobacterium tuberculosis was also identified by Xpert MTB/RIF assay. Cerebrospinal fluid analysis and brain computed tomographic scans showed tuberculous meningitis and tuberculoma. Antituberculosis therapy with rifampicin, isoniazid, pyrazinamide, and ethambutol; prednisolone; pyridoxine; and wound care were provided. The patient was discharged for outpatient directly observed antituberculosis therapy in a nearby health center after acute complications were treated and once the skin lesion had started to dry or heal. CONCLUSIONS: Cutaneous tuberculosis should be considered in a child presenting with a skin lesion or discharge. Cutaneous tuberculosis cases should be investigated for coexisting pulmonary and extrapulmonary forms of tuberculosis. Histopathologic diagnosis should be considered to rule out other skin pathologies and also to prevent delay in treatment. Better tuberculosis prevention strategies, including vaccination scale-up, are warranted.


Assuntos
Anti-Inflamatórios/uso terapêutico , Antituberculosos/uso terapêutico , Mycobacterium tuberculosis/isolamento & purificação , Pele/patologia , Tuberculose Cutânea/diagnóstico , Criança , Etambutol/uso terapêutico , Feminino , Humanos , Isoniazida/uso terapêutico , Pescoço/patologia , Prednisolona/uso terapêutico , Pirazinamida/uso terapêutico , Rifampina/uso terapêutico , Resultado do Tratamento , Tuberculose Cutânea/tratamento farmacológico
19.
Skinmed ; 16(5): 301-303, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30413222

RESUMO

The clinical diagnosis of cutaneous tuberculosis (CT) was based on criteria of reinfection and reactivation. Laboratory tests are mandatory but have limitations, thus demanding continuous innovation. In our study, we took punch biopsies from lesions on 48 patients. Half of these biopsies underwent histopathologic investigation, and the other half were analysed using the BACT Alert 3D system, the Amplified Mycobacterium Tuberculosis Direct Test (AMTDT), and DNA amplification by polymerase chain reaction (PCR) using primers specific for the M. tuberculosis 16SrRNA complex. Patients were given antitubercular therapy for 6 weeks. A positive response was indicative of CT. Histopathology was suggestive, although no acid-fast bacilli could be demonstrated. In vitro culture recovery of M. tuberculosis was possible in six (12.5%); only two (4%) were positive on AMTDT, and 14 (29%) on real-time PCR. Regression of skin lesions was remarkable after antitubercular therapy, irrespective of a laboratory result. AMTDT and real-time PCR are seen to be of low value in the diagnosis of CT. They are limited by high cost, their paucibacillary nature, and technical errors. On comparing has AMTDT and PCR, the latter was found to be superior. High percentages of negative results were also investigated; extensive involvement of skin has yielded positive PCR results, probably due to low immunity and high bacterial load.


Assuntos
Antituberculosos/uso terapêutico , DNA Bacteriano/isolamento & purificação , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose Cutânea/diagnóstico , Tuberculose Cutânea/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Resultado do Tratamento , Adulto Jovem
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