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Dermatological aspects of tularaemia: a study of 168 cases
Author(s) -
Polat M.,
Karapınar T.,
Sırmatel F.
Publication year - 2018
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/ced.13548
Subject(s) - medicine , dermatology , erythema nodosum , dermatological diseases , acne , vasculitis , erythema , disease , francisella tularensis , biochemistry , chemistry , virulence , gene
Summary Background Tularaemia is a zoonotic infectious disease caused by Francisella tularensis , an aerobic, uncapsulated, gram‐negative coccobacillus. Several case reports have appeared on the dermatological manifestations of tularaemia, but relatively few longer‐term studies are available. Aim To identify skin features of tularaemia that aid in its diagnosis. Methods In total, 168 patients (68 male, 100 female) diagnosed with tularaemia were retrospectively examined. All dermatological data for these patients were evaluated. Results Of the 168 patients, 149 (88.69%) had tularaemia of the oropharyngeal type, 12 (7.73%) had the ulceroglandular type, 5 (2.9%) had the oculoglandular type and 2 (0.59%) had the pulmonary type. Secondary skin manifestations were found in 26 patients (15.47%). Sweet syndrome ( SS ) was found in 11 patients (6.54%), most of whom presented with the oropharyngeal form, while erythema nodosum ( EN ) was found in 7 patients (4.16%), dermatitis in 2 (1.19%), urticaria in 2 (1.19%), acneiform eruptions in 1 (0.59%), vasculitis‐like eruptions in 1 (0.59%) and SS + EN in 1 (0.59%). Patients with the oropharyngeal form had a statistically significant ( P < 0.001) higher number of skin findings than patients with the other forms. Conclusions In clinical practice, tularaemia may present with various cutaneous manifestations, and dermatologists who work in endemic regions must be aware of the possibility of this disease.