RESUMO
BACKGROUND: Sarcoidosis is a multi-system granulomatous disease of unknown etiology. The skin is involved in 25% of cases. Studies on cutaneous sarcoidosis from our region are lacking. OBJECTIVES: This study was conducted to describe clinical and histopathologic findings in all patients diagnosed with cutaneous sarcoidosis at the American University of Beirut Medical Center between 1992 and 2010 and to compare findings with those published in the literature. METHODS: Clinical charts of patients with cutaneous sarcoidosis were retrospectively reviewed. Extracutaneous lesions were classified by organ involvement. Treatment was documented. Pathology specimens were reviewed. RESULTS: Cutaneous sarcoidosis was diagnosed in 76 Lebanese patients, 79% of whom were women. Mean age at diagnosis was 48 years. A total of 29% of patients had systemic disease that was commonly associated with lupus pernio lesions and subcutaneous sarcoidosis. The most common cutaneous lesions were sarcoidal plaques. The histopathologic features in our series did not differ from those described in the literature, except for the documented presence of a grenz zone. Interestingly, 23% of biopsy specimens contained perineural granulomas, raising the possibility of tuberculoid or borderline tuberculoid leprosy. Foreign bodies were detected in 10% of cases (all had systemic involvement), supporting the opinion that sarcoidosis and granulomatous foreign body reaction are not mutually exclusive. CONCLUSIONS: The clinical and histopathologic features of cutaneous sarcoidosis patients in the present series are generally comparable with those published in the literature, with minor differences. Clinically, the most commonly seen lesion was plaque. Microscopically, cutaneous sarcoidosis may exhibit a grenz zone and may show perineural inflammation and foreign bodies.
Assuntos
Sarcoidose/patologia , Dermatopatias/patologia , Adulto , Idoso , Feminino , Corpos Estranhos/complicações , Humanos , Líbano , Masculino , Pessoa de Meia-Idade , Nervos Periféricos , Estudos Retrospectivos , Sarcoidose/complicações , Sarcoidose Pulmonar/complicações , Dermatopatias/complicações , Adulto JovemAssuntos
Diabetes Mellitus Tipo 1/complicações , Sarcoidose/patologia , Dermatopatias/patologia , Adulto , Anti-Inflamatórios/uso terapêutico , Antirreumáticos/uso terapêutico , Humanos , Hidroxicloroquina/uso terapêutico , Masculino , Prednisolona/uso terapêutico , Sarcoidose/complicações , Sarcoidose/tratamento farmacológico , Sarcoidose Pulmonar/complicações , Sarcoidose Pulmonar/tratamento farmacológico , Dermatopatias/complicações , Dermatopatias/tratamento farmacológico , Vitiligo/complicações , Vitiligo/patologiaRESUMO
About a case of pulmonary and dermatologic manifestations of sarcoidosis, in a Black African patient, the authors emphasize the clinical polymorphism of sarcoidosis. They insist on the diagnostic criteria of sarcoidosis which are not at all specific of the disease but necessitate a compatible interpretation; particularly in Black Africa where leprosy, tuberculosis and many others granulomatous diseases are endemic.