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Annals of Dermatology 2010 ; 22(3): 341~345
Annals of Dermatology 2010 ; 22(3): 341~345

Three Cases of Primary Inoculation Tuberculosis as a Result of Illegal Acupuncture
Jin Ki Kim, M.D., Tae Yoon Kim, M.D., Dong Hyun Kim, M.D., Moon Soo Yoon, M.D.
Department of Dermatology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Primary inoculation tuberculosis results from the direct inoculation of Mycobacterium tuberculosis into the skin of a person who has no natural or artificially acquired immunity to the organism. The pathogenesis requires a break in the skin from an abrasion or injury that allows entry of the tubercle bacilli. We report 3 cases of primary inoculation tuberculosis resulting from illegal acupuncture. Three patients over 70 years old presented with erythematous, ulcerative, indurated plaques on the back. Skin lesions had developed at the acupuncture sites 1 or 2 weeks after a session of acupuncture, which was intended to relieve back pain. An unlicensed, non-medically trained person conducted each session. The patients' past medical and family histories were unremarkable. Granulomatous inflammatory infiltration and acid-fast bacilli were observed histologically. M. tuberculosis was identified by mycobacterial culture and polymerase chain reaction. Nine months after the initiation of antituberculosis medication, skin lesions improved, and no evidence of recurrence or other organ involvement was observed at the 1-year follow-up visit. (Ann Dermatol 22(3) 341∼345, 2010)
Annals of Dermatology 2010 ; 22(3): 341~345
Keyword : Acupuncture, Primary inoculation tuberculosis
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