Skin thickness affects the result of tuberculin skin test in systemic sclerosis.
Diagnostic study
Latent tuberculosis
Mycobacterium tuberculosis
Scleroderma
Systemic sclerosis
Tuberculin skin test
Journal
BMC rheumatology
ISSN: 2520-1026
Titre abrégé: BMC Rheumatol
Pays: England
ID NLM: 101738571
Informations de publication
Date de publication:
13 Aug 2022
13 Aug 2022
Historique:
received:
26
02
2022
accepted:
25
05
2022
entrez:
12
8
2022
pubmed:
13
8
2022
medline:
13
8
2022
Statut:
epublish
Résumé
Skin thickness is a prominent clinical feature of systemic sclerosis (SSc), but there is no consensus on the cut-off for a positive tuberculin skin test (TST) size and the limitation of the TST for a diagnosis of tuberculosis in SSc. We aimed to identify the cut-off size of an indurated TST and the sensitivity and specificity of the test for the diagnosis of tuberculosis in SSc patients. A cross-sectional study of 168 adult Thai SSc patients was conducted. The TST was done using 0.1 ml of purified protein derivatives via intradermal injection. The test was interpreted 72 h after testing. The median age was 57.2 years. The majority (71.8%) had the diffuse cutaneous SSc subset. All the patients had a BCG vaccination at birth, and 17 (10.1%) had a tuberculosis infection. An indurated skin reaction size of 20 mm had the highest specificity for tuberculosis (99.3%: 95%CI 96.4-100) (ROC 0.53). The skin thickness-assessed using the modified Rodnan skin score (mRSS)-had a significant negative correlation with the reaction size (Rho -0.23; p = 0.003). The TST is not sufficiently sensitive for detecting TB infection in SSc patients, albeit a skin induration of ≥ 15 mm indicates a high specificity for tuberculosis infection. A high mRSS resulted in a smaller skin reaction size when using the TST, which has limited utility as a diagnostic for tuberculosis among SSc patients with severe skin thickness. The manuscript was presented as a poster presentation at the Annual European Congress of Rheumatology EULAR 2019 Madrid 12-15 June 2019. (Ann Rheum Dis. 2019;78(suppl 2): abstract FRI0347) http://dx.doi.org/10.1136/annrheumdis-2019-eular.1456.
Sections du résumé
BACKGROUND
BACKGROUND
Skin thickness is a prominent clinical feature of systemic sclerosis (SSc), but there is no consensus on the cut-off for a positive tuberculin skin test (TST) size and the limitation of the TST for a diagnosis of tuberculosis in SSc. We aimed to identify the cut-off size of an indurated TST and the sensitivity and specificity of the test for the diagnosis of tuberculosis in SSc patients.
METHODS
METHODS
A cross-sectional study of 168 adult Thai SSc patients was conducted. The TST was done using 0.1 ml of purified protein derivatives via intradermal injection. The test was interpreted 72 h after testing.
RESULTS
RESULTS
The median age was 57.2 years. The majority (71.8%) had the diffuse cutaneous SSc subset. All the patients had a BCG vaccination at birth, and 17 (10.1%) had a tuberculosis infection. An indurated skin reaction size of 20 mm had the highest specificity for tuberculosis (99.3%: 95%CI 96.4-100) (ROC 0.53). The skin thickness-assessed using the modified Rodnan skin score (mRSS)-had a significant negative correlation with the reaction size (Rho -0.23; p = 0.003).
CONCLUSION
CONCLUSIONS
The TST is not sufficiently sensitive for detecting TB infection in SSc patients, albeit a skin induration of ≥ 15 mm indicates a high specificity for tuberculosis infection. A high mRSS resulted in a smaller skin reaction size when using the TST, which has limited utility as a diagnostic for tuberculosis among SSc patients with severe skin thickness. The manuscript was presented as a poster presentation at the Annual European Congress of Rheumatology EULAR 2019 Madrid 12-15 June 2019. (Ann Rheum Dis. 2019;78(suppl 2): abstract FRI0347) http://dx.doi.org/10.1136/annrheumdis-2019-eular.1456.
Identifiants
pubmed: 35962447
doi: 10.1186/s41927-022-00278-8
pii: 10.1186/s41927-022-00278-8
pmc: PMC9375415
doi:
Types de publication
Journal Article
Langues
eng
Pagination
48Informations de copyright
© 2022. The Author(s).
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