Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fifty-four patients with cutaneous tuberculosis, consisting of 23 with lupus vulgaris, 22 with scrofuloderma, and nine with verrucosa cutis, were investigated for cell-mediated immunity, through estimation of peripheral total T lymphocytes (CD3+), CD4+ (helper/inducer), and CD8+ (cytotoxic/suppressor) lymphocytes, by immunohistochemical staining of peripheral blood smears, using specific monoclonal antibodies and the alkaline phosphatase-antialkaline phosphatase (APAAP) method. Absolute values of total T lymphocytes (CD3+), and CD4+ and CD8+ subsets, were found to be significantly raised in scrofuloderma, but the percentage values and the CD4+/CD8+ ratio remained unaltered. In tuberculosis verrucosa cutis, only the percentage of the CD8+ subset of T lymphocytes was found to be significantly lowered, and this altered the CD4+/CD8+ ratio. No significant change was observed in the peripheral blood T cells and their subpopulations in patients suffering from lupus vulgaris.
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PMID:Peripheral T lymphocytes and their subsets in cutaneous tuberculosis. 155 33

Three antituberculous drug regimens have been employed to study the therapeutic response in 90 patients with any one of the commonly encountered paucibacillary forms of skin tuberculosis, namely lupus vulgaris, tuberculosis verrucosa cutis and scrofuloderma. The first two regimens contained rifampicin, isoniazid and either pyrazinamide or thiacetazone, and the third regimen had rifampicin and isoniazid only. The disease was clinically defined as localized when confined to one area and widespread when the lesions were disseminated. The observations revealed that the response of lupus vulgaris and tuberculosis verrucosa cutis was alike in all the three regimens, with the localized lesions subsiding completely after 4 months of therapy and the more extensive forms taking 5 months. Patients with scrofuloderma responded similarly to both the triple drug regimens. The discharge, sinuses and ulcers cleared in 6 months but the lymph nodes took longer to regress, up to 7 months in localized and 9 months in more widespread scrofuloderma. To obtain the same results with rifampicin and isoniazid, all patients with widespread scrofuloderma and one-third of those with localized forms had to be treated for 10 and 9 months, respectively. No serious drug side-effects, apart from giddiness with rifampicin and acneiform eruptions with thiacetazone, were encountered. No instances of relapse were noted in the 50% of patients who were followed-up for 3 1/2 years after therapy. Single-drug therapy with isoniazid for lupus vulgaris, as given in the past, is to be discouraged as it may promote the emergence of drug-resistant bacilli in those with an undetected focus of infection.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comparative efficacy of drug regimens in skin tuberculosis. 170

During the past 3 years, we have seen a changing pattern of cutaneous tuberculosis, in which its incidence was recorded to show an upward trend affecting predominantly the adult men. The latter was true in reinfection--lupus vulgaris and tuberculosis verrucosa cutis, whereas a substantial number of children were victims of reactivation--scrofuloderma. The duration of the disease was usually short in reactivation tuberculosis. Its clinical expression, however, conformed largely to the ritual text except that apple-jelly nodules were infrequently demonstrated. Similarly, the morbidity was low. The affliction of the extremities in lupus vulgaris, in particular, was a contrasting feature. The histopathology invariably either confirmed or supplemented the clinical impression. The ultimate confirmation of cutaneous tuberculosis was done only by the demonstration of Mycobacterium tuberculosis in smears, or its recovery in vitro. In view of the limitations of the preceding parameters, the diagnosis may reasonably be made based on the history and evolution of the disease, cardinal morphologic features of reinfection and reactivation tuberculosis, and histopathologic characteristics. A response to antitubercular drugs may be of assistance.
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PMID:Changing pattern of cutaneous tuberculosis. A prospective study. 249 16

Cutaneous tuberculosis incidence was recorded as 0.15%. Of the 42 patients, 23 had scrofuloderma, 17 lupus vulgaris, and 2 tuberculosis verrucosa cutis. Both men and women were affected by the disease in the second and third decades. Its duration was variable. An affirmative family history was elicited in five scrofuloderma patients. The clinical expression largely conformed to the ritual text. Variation in Mantoux test positivity was unremarkable. The disparity in the demonstration of bacilli in the smear and tissue sections was, however, quite apparent in scrofuloderma. The correlation of different parameters indicates a continuous spectrum, formed at one end by lupus vulgaris, and at another by scrofuloderma. A moderate to strongly positive Mantoux text, enormous lymphocytes in the granuloma, absence of tubercle bacilli, negative culture, and an apparently normal immunoprofile were features of lupus vulgaris; whereas scrofuloderma had a moderately positive Mantoux test, lesser number of lymphocytes in the granuloma, large number of bacilli in tissue smear and/or tissue section, raised levels of immunoglobulins, and a grossly lowered C3 levels. The other variants probably occupy a position in between.
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PMID:An appraisal of epidemiologic, clinical, bacteriologic, histopathologic, and immunologic parameters in cutaneous tuberculosis. 311 6

One hundred patients with secondary skin tuberculosis--59 with lupus vulgaris (LV), 27 with scrofuloderma (SD), and 14 with tuberculosis verrucosa cutis (TVC)-were included in this study. The buttocks and lower limbs were seen to be important sites of involvement in LV, besides the occurrence over the face. An active focus of tuberculosis was present in 18, a past history of pulmonary tuberculosis in 8, and intrafamilial tuberculous infections in 21. Histopathology and culture for Mycobacterium tuberculosis were done in all the cases. Guinea pig inoculation was done in 11. The poor results of these investigations have been highlighted and discussed with reference to studies done in the past by other workers. The need for improvement in laboratory techniques is suggested.
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PMID:Secondary tuberculosis of the skin. Clinical features and problems in laboratory diagnosis. 344 25

We report two cases of lupus vulgaris one of them on scar of scrofuloderma. We review the treatment of the skin tuberculosis (TBC) and we observed the favorable development to the total regression, using rifampin-isoniazid-pyrizinamide in the first two months and rifampin-isoniazid the four months left to complete six months of global therapy. We discard the monotherapy as treatment for this disease.
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PMID:[Lupus vulgaris. Treatment with 3 drugs]. 771 16

The granulomas of lupus vulgaris (LV) were characterized by preponderance of CD4+ lymphocytes and a raised CD4+/CD8+ ratio. In contrast, in scrofuloderma (SF) the CD8+ T-lymphocyte subpopulation predominated and the CD4+/CD8+ ratio was significantly decreased. A higher percentage of lymphocytes expressed interleukin-2 receptor (IL-2R) in LV as compared with SF, indicating an activated cellular immune response in the former. Immunophenotypic changes in tuberculosis verrucosa cutis (TBVC) were intermediate between LV and SF. CD4+ lymphocytes were the main infiltrating T-cell type in borderline tuberculoid leprosy (BT), while CD8+ lymphocytes predominated in the granuloma of lepromatous lepromatous (LL). The CD4+/CD8+ ratio and percentage of lymphocytes expressing IL-2R was significantly higher in BT as compared with LL. These immunophenotypic findings suggest that in both cutaneous tuberculosis and leprosy there is a continuous spectrum with regard to cell-mediated immunity depending on the clinical presentation.
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PMID:In situ characterization of lymphocytic immunophenotypes and interleukin-2 receptors in cutaneous tuberculosis and leprosy--a comparative evaluation. 795 72

Granulomas of lupus vulgaris were characterized by a raised CD4+/CD8+ ratio, while in scrofuloderma this was significantly decreased. Tuberculosis verrucosa cutis showed intermediate changes. These immunological variations suggest that cutaneous tuberculosis forms a spectrum with strong cell-mediated immunity seen in lupus vulgaris, and weaker cell-mediated responses in scrofuloderma; tuberculosis verrucosa cutis is intermediate between the two.
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PMID:Immunohistopathological spectrum in cutaneous tuberculosis. 840 63

Data collected prospectively on all 1065 cases of tuberculosis occurring in the Blackburn district, U.K. (population 265,000), over a 15-year period have been analysed, and from these 47 cases of cutaneous tuberculosis have been identified. The most common form was scrofuloderma, skin involvement with adjacent structural disease, of which there were 26 cases (55.3%). There was no ethnic bias in this group. The eight white patients with scrofuloderma were of average age 66 years, and are thought to represent reactivation disease. Six patients (12.8%) had lupus vulgaris, four (8.5%) had metastatic tuberculosis and 10 (21.3%) were diagnosed as having one of the tuberculides, of which Bazin's disease (erythema induratum) was the most common. In addition, one patient (2.2%) had orificial tuberculosis. In contrast to scrofuloderma, all other forms of cutaneous tuberculosis occurred almost exclusively in patients from the Indian Subcontinent (ISC). The high incidence of tuberculosis in Blackburn is mainly linked to its significant proportion of residents of ISC ethnic origin. There were no cases of HIV infection coexisting with either cutaneous or other forms of tuberculosis. Recommendations for the treatment of cutaneous tuberculosis are made.
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PMID:Cutaneous tuberculosis in Blackburn district (U.K.): a 15-year prospective series, 1981-95. 915 44

Sixty-three children out of a total of 199 patients seen with cutaneous tuberculosis during a 7-year period were included in this study. Culture was positive in only four, and the diagnosis was based on clinical examination, tuberculin reaction, histopathology, and response to antitubercular therapy. Forty had lupus vulgaris (LV) and 23 scrofuloderma (SD). The lower half of the body was predominantly affected in those with LV, and keratotic and hypertrophic forms were frequently encountered. LV planus mainly affected the face. Ulcerative and atrophic types of LV were infrequent. Extensive lesions in three children led to disfiguring scars and contractures. Scrofuloderma often involved the cervical group of lymph nodes followed by the inguinal, submandibular, and axillary groups. As compared to skin tuberculosis in adults, regional lymph node involvement in LV was more common, and a combination of both LV and SD was less frequent in children. No difference in clinical presentation could be detected between the BCG vaccinated and unvaccinated children. Tuberculous infection either in the lungs or the bones was present in eight children. An HIV test done in five patients with widespread lesions was negative. Irregular therapy or late diagnosis leading to serious complications, inadequate parental or community support, and lack of awareness among practitioners are the problems to be remedied.
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PMID:A study of cutaneous tuberculosis in children. 1046 8


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