Polymerase chain reaction compared to other laboratory findings and to clinical evaluation in the diagnosis of cutaneous tuberculosis and atypical mycobacteria skin infection.
BACKGROUND
Cutaneous tuberculosis has re-emerged in the last 15 years together with the higher incidence of pulmonary tuberculosis and multidrug resistance. The choice for a single diagnostic tool among the many available today is a challenge. Our objective was to compare polymerase chain reaction (PCR) with other exams in the diagnosis of cutaneous tuberculosis and atypical mycobacteria skin infection.


METHODS
PCR and a set of five different exams were performed in 32 patients (34 samples of paraffin-embedded tissue) evaluated for 3 years in a university hospital, considering the response to mycobacterial infection treatment as a positive case.


RESULTS
PCR was the most sensitive (88%) and specific (83%) exam. Culture, immunohistochemistry and acid-fast bacilli were not in agreement with clinical response to treatment. Conclusions Although PCR is a useful tool, careful clinical exam is still the gold standard for the evaluation and treatment of cutaneous tuberculosis and mycobacteria skin infection.
Abdalla
Cristina Martinez Zugaib
CM
Department of Dermatology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil. abdalla@ip2.com.br
de Oliveira
Zilda Najjar Prado
ZN
Sotto
Mirian N
MN
Leite
Kátia Ramos Moreira
KR
Canavez
Flávio Canellas
FC
de Carvalho
Cláudia Muraro
CM
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001707:Biopsy, Needle; D001938:Brazil / Q000453:epidemiology; D015331:Cohort Studies; D004269:DNA, Bacterial / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis* / Q000453:epidemiology; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D017192:Skin Diseases, Bacterial / Q000175:diagnosis* / Q000453:epidemiology; D014374:Tuberculin Test; D014382:Tuberculosis, Cutaneous / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult
D004269:DNA, Bacterial