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**''M. ulcerans'' = Buruli ulcer
**''M. chelonae''
**''M. marinum'' - highest incidence
**''M. avium'' - long-maintained hot bath
編集の要約なし
*non-TB mycobacterium (NTM)
**water-borne
==when to suspect==
**MB in WHO classification
**macule, papule, nodule
**multiple skin lesion
**widespread, symmetrical
**loss of sensation at ...
***in histopathology diffuse infiltrate of foamy histiocytes (macrophages) in dermis
***Leonine facies: madarosis, saddle nose
===diagnosis===
*WHO criteria: one or more cardinal signs
#skin lesion consistent with leprosy with definite sensory loss
#thickened nerve, peripheral neuropathy
#skin smear...
===treatment===
*MB >5 lesions
**
*PB 1-5 lesions
**
===leprosy reaction===
*can develop at anytime on clinical course
**either before or after commencement of treatment
**even after completion of treatment
*incidence 20-60% in multiple studies
*
*Type 1 reversal reaction
**cell-mediated delayed hypersensitivity
**reddish, swollen, warm, painful, tender
**systemic condition fair
*Type 2 erythema nodosum leprosum (ENL)
**antigen-antibody immune complex reaction
**multiple, distributed bilaterally and symmetrically
**with high grade fever and malaise
====treatment of leprosy reaction====
*antipyretics, NSAIDs
*steroid
*immunosuppressant
==cutaneous TB==
==skin NTM==
all manifest in similar skin lesions, eruptions
*''M. ulcerans'' = Buruli ulcer
*''M. chelonae''
*''M. marinum'' - highest incidence
**contact with tropical fish
*''M. avium''
**long-maintained hot bath
**hot spring
*''M. peregrinum''
*''M. massiliense'' (''M. abscessus'' subsp. ''massiliense)
