Cutaneous Manifestations Of Sarcoidosis Research Articles

Rare Scar Sarcoidosis: A Dermatologic Masquerader

Infiltration of sarcoid granuloma in old cutaneous scars is one of the uncommon cutaneous manifestations of sarcoidosis. Here we report the case of a 32-year-old female who presented with swelling and irritation in a 9-month-old appendicectomy scar. An incisional scar biopsy was done and it revealed non-caseating granuloma. On query she had inflammatory polyarthritis and persistent dry cough for last two months. High resolution CT (HRCT) revealed right paratracheal, both hilar, paraaortic, and subcarinal lymphadenopathy with pulmonary nodular densities in both lung fields. FNAC from mediastinal node revealed non-caseating granuloma consistent with sarcoidosis. Successful regression of cutaneous inflammation was achieved using a course of oral steroids, hydroxychloroquine and methotrexate. The incidence of scar sarcoidosis is rare and therefore not well-understood. However, inflammatory alterations in preexisting scars may be important indicators of disease onset.
 J Enam Med Col 2020; 10(2): 122-125

Cutaneous Sarcoidosis: A Retrospective Clinico-Pathological Study from the Indian Subcontinent in Patients Attending a Tertiary Health Care Centre.

Context:Sarcoidosis is a systemic disorder characterized histologically by noncaseating granulomas. There is paucity of Indian data on cutaneous sarcoidosis.Aims:To describe the clinical, histopathological findings, and extracutaneous involvement in cutaneous sarcoidosis.Materials and Methods:A retrospective study was done in patients of cutaneous sarcoidosis who had attended the dermatology clinic of a tertiary health care center in India from May 2009 to April 2015. The clinical details, histopathological findings, treatment, and response were reviewed.Results:There were 38 patients with cutaneous sarcoidosis. Mean age was 48 ± 13 years; 58% were female. Median duration of disease was 11 months (IQR 4–48 months). More than one morphology was seen in 28.9%, commonest being plaques (65.7%), and papules (50%). Erythema nodosum was rare. More than one site was involved in 55.3%, most commonly trunk (52.6%). Six patients had isolated cutaneous sarcoidosis. Commonest extracutaneous organs involved were lung (73.7%) and lymph nodes (68.4%). Histopathologically, classical naked sarcoidal granulomas were found in only 55.3%. Angiotensin converting enzyme (ACE) levels were elevated in 74.3% (26/35) with significant association with extracutaneous disease. Treatment included topical and/or systemic corticosteroids, hydroxychloroquine, and tacrolimus.Statistics:Pearson's Chi-square test was done to analyze associations between the skin lesions, ACE levels, and systemic involvement; P < 0.05 was considered significant.Conclusions:Cutaneous manifestations of sarcoidosis are varied, commonest being erythematous plaques. Even though most patients had systemic involvement, we found no significant association of the type and number of skin lesions with extracutaneous involvement or prognosis. Elevated ACE levels were significantly associated with systemic involvement.

Practice gaps in the evaluation of systemic involvement in patients with cutaneous sarcoidosis presenting to a dermatologist: A retrospective review of 48 patients

Sarcoidosis is a systemic granulomatous disorder of unknown etiology with a variable prognosis. The skin is one of the organs most commonly affected, with up to 30% of cases involving the skin.1 Because the cutaneous manifestations of sarcoidosis often present at disease onset,1 a dermatologists may be the first physician to diagnose a patient with sarcoidosis. As such, dermatologists are often responsible for initiating the appropriate evaluation of patients with sarcoidosis.

Cutaneous Sarcoidosis.

Sarcoidosis is a chronic, multisystem, inflammatory disorder of unknown etiology that is characterized by noncaseating granulomas that impair normal organ functioning. Sarcoidosis predominantly affects the lungs, but the skin is often cited as the second most frequently involved organ. Cutaneous manifestations of sarcoidosis are highly variable and ongoing research seeks to better understand the relationship between clinical morphology and disease prognosis. Skin findings in patients with sarcoidosis can be "specific," in which sarcoidal granulomas infiltrate the skin, or they can represent a "nonspecific" reactive inflammatory process, as is seen in calcinosis cutis and erythema nodosum. Cutaneous sarcoidosis can be the initial presenting sign or develop later in the course of the disease. In some patients, the skin will be the most involved and impactful organ system and will drive therapy. In other cases, the skin will be an incidental or minor finding, but may be easily accessible for biopsy to confirm the diagnosis. There are many potential therapies for sarcoidosis, though no one therapy is universally effective.

Cutaneous sarcoidosis: a case report from North-East India

&lt;p&gt;Sarcoidosis is a multisystem granulomatous disease of unknown aetiology. Cutaneous sarcoidosis is seen in up to one-third of patients and may be the first or the only clinical sign of the disease. We report a case of cutaneous sarcoidosis with lungs and renal involvement in a 28-year-old housewife. She presented with itchy reddish-brown indurated plaques on left cheek and back for 2 years. Skin biopsy revealed non-caseating epithelioid granulomas. Contrast enhanced computed tomography thorax showed focal consolidation and multiple enlarged mediastinal lymph nodes and serum angiotensin-converting enzyme level was raised. Since cutaneous manifestations of sarcoidosis are extremely variable, its early recognition can provide a clue to the diagnosis and its systemic involvement. &lt;/p&gt;

Biologic Therapy in the Treatment of Cutaneous Sarcoidosis: A Literature Review.

Sarcoidosis is an inflammatory disease defined by the presence of non-caseating granulomas. It can affect a number of organ systems, most commonly the lungs, lymph nodes, and skin. Cutaneous manifestations of sarcoidosis can impose a significant detriment to patients' quality of life. The accepted first-line therapy for cutaneous sarcoidosis consists of intralesional and oral corticosteroids, but these can fail in the face of resistant disease and corticosteroid-induced adverse effects. Second-line agents include tetracyclines, hydroxychloroquine, and methotrexate. Biologics are an emerging treatment option for the management of cutaneous sarcoidosis, but their role in management is not well-defined. In this article, we reviewed the currently available English-language publications on the use of biologics in managing cutaneous sarcoidosis. Although somewhat limited, the data in published studies support the use of both infliximab and adalimumab as third-line treatments for chronic or resistant cutaneous sarcoidosis. There were also scattered reports of etanercept, rituximab, golimumab, and ustekinumab being utilized as third-line agents with varying degrees of success. Larger and more extensive investigations are required to further assess the adverse effect profile and optimal dosing for managing cutaneous sarcoidosis.

Scalp Sarcoidosis Presenting as Cicatricial Alopecia

Sarcoidosis is a granulomatous condition that has a highly variable presentation. One rare presentation of sarcoidosis is cutaneous scalp sarcoidosis. Usually scalp sarcoid presents as a scarring alopecia, but it can be nonscarring. The presence of sarcoidal lesions on the scalp is associated with systemic disease, as are other cutaneous manifestations of sarcoidosis. The authors present the case of a 64-year-old woman with a history of sarcoidosis who presented with alopecia and hypopigmented patches on her scalp. She also had papular sarcoid lesions on her upper back and a history of pulmonary involvement, which is consistent with previous reports in the literature. The condition subsequently improved with topical clobetasol propionate.

Cutaneous manifestations of sarcoidosis

Skin manifestations of sarcoidosis occur in up to 30% of cases. This review summarizes and illustrates in detail the differences between specific and unspecific skin manifestations of sarcoidosis. Important differential diagnoses, such as tuberculosis, cutaneous lymphoma and syphilis have to be excluded. The indications for systemic treatment are primarily determined by the extent of organ involvement and also by the cosmetic impairment.

Sarcoidosis in Melanoma Patients: Case Report and Literature Review.

Sarcoidosis is a systemic inflammatory disease characterized by the development of noncaseating granulomas in multiple organ systems. Many hematologic malignancies and solid tumors, including melanoma, have been associated with sarcoidosis. We describe the clinical and pathologic findings of a 54-year-old man with melanoma-associated sarcoidosis. In addition, we not only review the literature describing characteristics of other melanoma patients with sarcoidosis, but also the features of melanoma patients with antineoplastic therapy-associated sarcoidosis. Sarcoidosis has been described in 80 melanoma patients; sufficient information for analysis was provided in 39 of these individuals. In 43.6% of individuals (17 out of 39), sarcoidosis was directly associated with melanoma; in 56.4% of oncologic patients (22 out of 39), sarcoidosis was induced by antineoplastic therapy that had been administered for the treatment of their metastatic melanoma. The discovery of melanoma preceded the development of sarcoidosis in 12 of the 17 (70.5%) individuals who did not receive systemic treatment. Pulmonary and/or cutaneous manifestations of sarcoidosis were common among both groups of patients. Most patients did not require treatment for sarcoidosis. Melanoma patients—either following antineoplastic therapy or without systemic treatment—may be at an increased risk to develop sarcoidosis. In antineoplastic therapy naive melanoma patients, a common etiologic factor—such as exposure to ultraviolet light—may play a role in their developing melanoma and sarcoidosis.

The Scar Sign

Scar involvement is a rare but characteristic cutaneous manifestation of sarcoidosis. The concurrent presence of FDG-avid lymphadenopathy and scar involvement (the "scar sign") is a useful finding on FDG PET/CT to suggest sarcoidosis, especially when biopsy specimens are difficult to obtain. A 46-year-old woman who presented with fever, cough, and weight loss was found to have mediastinal and hilar lymphadenopathy on chest radiography and CT scan. FDG PET/CT scan showed FDG-avid lower cervical, mediastinal, hilar, and inguinal lymphadenopathy. There was also increased FDG uptake along an old hysterectomy scar. Mediastinoscopy and nodal biopsy revealed noncaseating granulomas compatible with sarcoidosis.

Ichthyosiform sarcoidosis revisited

Cutaneous manifestations of sarcoidosis are present in approximately one-third of the cases. Ichthyosiform lesion is one of the extremely rare cutaneous manifestations of sarcoidosis. It is a uncommon, but specific cutaneous manifestation of sarcoidosis that may precede or appear simultaneously with the diagnosis of systemic sarcoidosis. Approximately 20 cases of ichthyosiform sarcoidosis have been reported in the PubMed database. We report here a case of sarcoidosis with ichthyosiform skin lesions along with central nervous system (CNS) and pulmonary involvement for its rarity and interesting clinical presentation.

Cutaneous manifestations of sarcoidosis

Cutaneous manifestations of sarcoidosis

Papular sarcoidosis accompanied with anterior uveitis

Sarcoidosis is a multi-systemic non-caseating granulomatous disorder of unknown origin. The cutaneous manifestations of sarcoidosis often enable the dermatologist to be the first physician to make the diagnosis. In the Western countries, maculopapular lesions are the most common cutaneous manifestation of granulomatous involvement in sarcoidosis. However, subcutaneous sarcoidosis has been known to be most common subtype in the Korean literature. Herein, we present a rare case of papular sarcoidosis accompanied with chronic anterior uveitis.

Papular sarcoidosis accompanied with anterior uveitis

Sarcoidosis is a multi-systemic non-caseating granulomatous disorder of unknown origin. The cutaneous manifestations of sarcoidosis often enable the dermatologist to be the first physician to make the diagnosis. In the Western countries, maculopapular lesions are the most common cutaneous manifestation of granulomatous involvement in sarcoidosis. However, subcutaneous sarcoidosis has been known to be most common subtype in the Korean literature. Herein, we present a rare case of papular sarcoidosis accompanied with chronic anterior uveitis.

Un caso inusual de sarcoidosis de las cicatrices

—Sarcoidosis is a multisystemic disorder of unknown etiology, mostly affecting young adults, and characterized by formation of noncaseating epithelioid-cell granulomas in several organs. Usually sarcoidosis involves lungs, lymph nodes, eyes and skin. Cutaneous manifestations of sarcoidosis are of two types: specific, with noncaseating granulomas, and nonspecific, such as erythema nodosum. Infiltration of old scars is a specific manifestation of sarcoidosis. We report a case of a young woman who referred changes in scars due to a gas explosion. The histological study showed sarcoid granulomas affecting the whole dermis. She showed alterations in hepatic function tests. Five months later the patient suffered an uveitis. Scar sarcoidosis may be the first and single manifestation of systemic sarcoidosis.

Sarcoidosis

Sarcoidosis is a systemic noncaseating granulomatous disorder of unknown origin. The cutaneous manifestations of sarcoidosis often enable the dermatologist to be the first physician to make the diagnosis. This article reviews essential sarcoidosis pathophysiology, clinical polymorphisms, systemic evaluation, and treatment modalities for cutaneous sarcoidosis to further enhance the dermatologist's understanding of this disease entity. (J Am Acad Dermatol 2001;44:725-43.) Learning objective: At the conclusion of this learning activity, participants should be familiar with the theories of the pathogenesis of sarcoidosis, its cutaneous manifestations, its various syndromes and associations, and its presentation in children. Participants should also be more knowledgeable about diagnostic evaluation, measurement of disease progression, treatment modalities, and the prognosis and mortality data of sarcoidosis.

Cutaneous manifestation of sarcoidosis ( Boeck) with severe osseous destruction of the midface : A case report

A 16-year-old Caucasian girl presented with brownish red plaques and papules beneath the right eye, and a right side open bite. The cutaneous changes had occurred more than 13 years previously. Radiological evaluation of the chest demonstrated bilateral hilar lymphadenopathy. Kveim-Siltzbach test of the skin was positive. Histological examination of several biopsy specimens taken from skin, oral mucosa and anterior wall of the right paranasal sinus revealed the diagnosis of sarcoidosis (Boeck). Therefore steroid therapy was initiated and the patient was placed on 40 mg prednisone daily. Under this treatment the sarcoidosis manifestations improved generally, and the prednisone dose was subsequently reduced.

Cutaneous manifestations of sarcoidosis. Relationships to other organ system involvement, abnormal laboratory measurements, and disease course

Cutaneous manifestations of sarcoidosis. Relationships to other organ system involvement, abnormal laboratory measurements, and disease course

Cutaneous Sarcoidosis Associated With Sarcoidosis of the Upper Airway

The diagnosis of laryngeal sarcoidosis is frequently delayed because it is rare and often develops insidiously. A 24-year-old woman with the annular scarring form of cutaneous sarcoidosis later contracted laryngeal sarcoidosis. Despite a two-year history of upper respiratory tract symptoms, the patient's progressive respiratory distress was attributed to sarcoidal pulmonary involvement. Dermatologists should be aware of the risk of airway obstruction from laryngeal granulomas in patients with cutaneous sarcoidosis. Although most commonly associated with the lupus pernio form of sarcoidosis, upper airway granulomas also develop in patients with other cutaneous manifestations of sarcoidosis.