Sarcoïdose cutanée ulcérée et diffuse survenant sur cicatrices

Abstract

Sarcoidosis in patients of African or Afro-Caribbean origin presents semiological characteristics, together with polymorphic skin lesions, more extensive forms and a poorer prognosis. Ulcerated and particularly diffuse skin forms are very rare. Herein we report a case of diffuse ulcerated skin sarcoidosis appearing on top of old scars in a female patient of Afro-Caribbean origin. A 16-year-old Caribbean girl consulted for multiple painful papules that appeared on old burns scars. The skin biopsy was consistent with sarcoidosis. At the same time, the patient developed sarcoid uveitis, and sarcoid dactylitis was suspected. Shortly thereafter, painful and diffuse ulcerations appeared on pre-existing skin lesions. Systemic corticosteroid therapy resulted in clinical improvement, but corticosteroid-dependency warranted subsequent initiation of methotrexate. Ulcerated cutaneous forms of sarcoidosis are rare and are often associated with severe forms, and they should prompt screening for systemic damage. There do not appear to be any previous reports of the presentation of ulcerated and extensive skin sarcoidosis presenting on scars, as described in the present study.