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T. Heyl

Bio: T. Heyl is an academic researcher from University of Limpopo. The author has contributed to research in topics: Hair loss & Papulonecrotic tuberculid. The author has an hindex of 2, co-authored 2 publications receiving 65 citations.

Papers
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Journal ArticleDOI
TL;DR: The experience with cutaneous tuberculosis at Ga‐Rankuwa Hospital is reviewed, with a total of 92 cases of skin tuberculosis seen over the past 12 years, with Lupus vulgaris was the most common true infection and papulonecrotic tuberculid the mostCommon tuberculids.
Abstract: The experience with cutaneous tuberculosis at Ga-Rankuwa Hospital is reviewed. A total of 92 cases of skin tuberculosis was seen over the past 12 years. All recognized forms of cutaneous tuberculosis were encountered, plus some forms which were difficult to classify. Lupus vulgaris was the most common true infection and papulonecrotic tuberculid the most common tuberculid. The classification and pathogenetic mechanisms are briefly discussed.

51 citations

Journal ArticleDOI
T. Heyl1
TL;DR: It is suggested that the central hair loss is the result of tissue necrosis, while the surrounding alopecia is either due to precipitate and abnormal telogen caused by the digestive tick saliva which becomes progressively diluted and less destructive as it spreads through the tissues.
Abstract: Summary The clinical and histological findings in two cases of tick bite alopecia of the scalp are described and possible pathogenetic mechanisms discussed. It is suggested that the central hair loss is the result of tissue necrosis, while the surrounding alopecia is either due to precipitate and abnormal telogen caused by the digestive tick saliva which becomes progressively diluted and less destructive as it spreads through the tissues or alternatively to an unknown toxin present in the saliva of the offending tick.

15 citations


Cited by
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Journal ArticleDOI
TL;DR: Diagnosis of cutaneous tuberculosis is challenging and requires the correlation of clinical findings with diagnostic testing; in addition to traditional AFB smears and cultures, there has been increased utilization of PCR because of its rapidity, sensitivity and specificity.
Abstract: As we move into the 21st century, cutaneous tuberculosis has re-emerged in areas with a high incidence of HIV infection and multi-drug resistant pulmonary tuberculosis. Mycobacterium tuberculosis, Mycobacterium bovis, and the BCG vaccine cause tuberculosis involving the skin. True cutaneous tuberculosis lesions can be acquired either exogenously or endogenously, show a wide spectrum of morphology and M. tuberculosis can be diagnosed by acid-fast bacilli (AFB) stains, culture or polymerase chain reaction (PCR). These lesions include tuberculous chancre, tuberculosis verrucosa cutis, lupus vulgaris, scrofuloderma, orificial tuberculosis, miliary tuberculosis, metastatic tuberculosis abscess and most cases of papulonecrotic tuberculid. The tuberculids, like cutaneous tuberculosis, show a wide spectrum of morphology but M. tuberculosis is not identified by AFB stains, culture or PCR. These lesions include lichen scrofulosorum, nodular tuberculid, most cases of nodular granulomatous phlebitis, most cases of erythema induratum of Bazin and some cases of papulonecrotic tuberculid. Diagnosis of cutaneous tuberculosis is challenging and requires the correlation of clinical findings with diagnostic testing; in addition to traditional AFB smears and cultures, there has been increased utilization of PCR because of its rapidity, sensitivity and specificity. Since most cases of cutaneous tuberculosis are a manifestation of systemic involvement, and the bacillary load in cutaneous tuberculosis is usually less than in pulmonary tuberculosis, treatment regimens are similar to that of tuberculosis in general. In the immunocompromised, such as an HIV infected patient with disseminated miliary tuberculosis, rapid diagnosis and prompt initiation of treatment are paramount. Unfortunately, despite even the most aggressive efforts, the prognosis in these individuals is poor when multi-drug resistant mycobacterium are present. An increased awareness of the re-emergence of cutaneous tuberculosis will allow for the proper diagnosis and management of this increasingly common skin disorder.

224 citations

Book ChapterDOI
06 May 2010

95 citations

Journal ArticleDOI
TL;DR: A disease model is presented incorporating polygenic determination of disease severity and susceptibility with largely unknown trigger factors responsible for initiating clinical disease expression.

90 citations

Journal ArticleDOI
TL;DR: Sixty‐three children out of a total of 199 patients seen with cutaneous tuberculosis during a 7‐year period were included in this study, and no difference in clinical presentation could be detected between the BCG vaccinated and unvaccinated children.
Abstract: 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.

89 citations

Journal ArticleDOI
TL;DR: The high incidence of tuberculosis in Blackburn is mainly linked to its significant proportion of residents of ISC ethnic origin and there were no cases of HIV infection coexisting with either cutaneous or other forms of tuberculosis.
Abstract: Summary 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 2b 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 palients (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.

79 citations