Skip to content
BY-NC-ND 3.0 license Open Access Published by De Gruyter Open Access June 1, 2011

A middle-age woman with subcutaneous plaque and hilar adenopathies

Husein Husein-ElAhmed EMAIL logo , Jose-Luis Callejas-Rubio and Norberto Ortego-Centeno
From the journal Open Medicine

Abstract

Subcutaneous sarcoidosis (SS) is an unusual and specific subtype of nodular sarcoidosis 1. The presence of SS with no elements of systemic manifestations is a rare condition: it is reported only in 1.4% to 6% of patients with systemic sarcoidosis, with the trunk being the most predilected area. Such cases with rare presentation are challenging for physicians because it can mimic several chronic infections, amyloidosis, hypothyroidism, lysosomal storage diseases and other conditions. Typical imaging (specially bilateral hilar adenopathies), histological exam and laboratory findings are the baseline to establish the diagnosis of sarcoidosis. In our case, the presence of subcutaneous manifestations avoided the performance of invasive procedures to get confirmation from other target organs: The epithelioid cells granulommas in subcutaneous fat and the representative radiological images were enough features to make the certain diagnosis. The first-line therapy for SS is oral steroids (20–40 mgr/day) with responses observed only 4–8 weeks after initiation of the treatment2. Prognosis of SS is good with spontaneous remission in some cases; however, when granulommas or fibrosis involves vital organs sarcoidosis can be life-threatening. Physicians should consider diagnosis of SS in patients with clinical suspicious history as sometimes skin manifestations are the first sign of systemic presentation of disease

[1] Rodríguez-Lojo R, Almagro M, Barja JM et al. Subcutaneous Sarcoidosis during Pegylated Interferon Alfa and Ribavirin Treatment for Chronic Hepatitis C. Dermatol Res Pract. 2010;2010:230417. 10.1155/2010/230417Search in Google Scholar PubMed PubMed Central

[2] Marcoval J, Moreno A, Mañá J, Peyri J. Subcutaneous sarcoidosis. Dermatol Clin. 2008 Oct;26(4):553–556. http://dx.doi.org/10.1016/j.det.2008.05.00310.1016/j.det.2008.05.003Search in Google Scholar PubMed

[3] Bosnić D, Baresić M, Bagatin D, Ilić I. Subcutaneous sarcoidosis of the face. Intern Med. 2010;49(6):589–592 http://dx.doi.org/10.2169/internalmedicine.49.293010.2169/internalmedicine.49.2930Search in Google Scholar PubMed

[4] Nishiyama Y, Yamamoto Y, Fukunaga K, Takinami H, Iwado Y, Satoh K, Ohkawa M.Comparative evaluation of 18F-FDG PET and 67Ga scintigraphy in patients with sarcoidosis. J Nucl Med. 2006 Oct;47(10):1571–1576. Search in Google Scholar

[5] Ainslie GM, Benatar SR. Serum angiotensin converting enzyme in sarcoidosis: sensitivity and specificity in diagnosis: correlations with disease activity, duration, extra-thoracic involvement, radiographic type and therapy. Q J Med. 1985 Jun;55(218):253–270. Search in Google Scholar

[6] Marcoval J, Mana J, Moreno A, Peyri J. Subcutaneous sarcoidosis clinicopathological study of 10 cases. Br J Dermatol 2005;153:790–794. http://dx.doi.org/10.1111/j.1365-2133.2005.06815.x10.1111/j.1365-2133.2005.06815.xSearch in Google Scholar PubMed

Published Online: 2011-6-1
Published in Print: 2011-8-1

© 2011 Versita Warsaw

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Downloaded on 28.11.2022 from frontend.live.degruyter.dgbricks.com/document/doi/10.2478/s11536-011-0029-x/html
Scroll Up Arrow