Systemic Sarcoidosis Presenting in a Scar

While most forms of sarcoidosis of the skin do not require treatment, 40% of patients initially diagnosed with cutaneous sarcoidosis are found to have an asymptomatic disease involving other organ systems. It is the involvement of the lungs, heart, eyes, and nervous system which most often contribut...

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Main Authors: Amy Xiao, Lauryn M. Falcone, Joseph C. English III
Format: Article
Language:English
Published: Hindawi Limited 2023-01-01
Series:Case Reports in Dermatological Medicine
Online Access:http://dx.doi.org/10.1155/2023/7751754
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author Amy Xiao
Lauryn M. Falcone
Joseph C. English III
author_facet Amy Xiao
Lauryn M. Falcone
Joseph C. English III
author_sort Amy Xiao
collection DOAJ
description While most forms of sarcoidosis of the skin do not require treatment, 40% of patients initially diagnosed with cutaneous sarcoidosis are found to have an asymptomatic disease involving other organ systems. It is the involvement of the lungs, heart, eyes, and nervous system which most often contributes to morbidity/mortality. An early and accurate diagnosis of sarcoidosis is difficult because patients may be asymptomatic, initial presentations may vary, and there is no single reliable diagnostic test except biopsy. We present a case of scar sarcoidosis which led to the diagnosis of stage II pulmonary sarcoidosis in a woman in her 50s. Her scar sarcoidosis presented as well-circumscribed, reddish-brown macules surrounding an atrophic scar from a prior skin graft on the right leg. Biopsy revealed scattered, well-formed, non-necrotizing granulomas of the dermis composed of epithelioid histiocytes and multinucleated giant cells, surrounded by a sparse infiltrate of lymphocytes and histiocytes. A CT chest demonstrated extensive hilar lymphadenopathy, leading to a diagnosis of stage II pulmonary sarcoidosis with cutaneous involvement. This case illustrates the interesting presentation of scar sarcoidosis and underscores the importance of a broad differential including sarcoidosis for skin changes around scars and underscores the need for early biopsy. Prompt cutaneous diagnosis leads to earlier systemic evaluation, therapeutics, and better outcomes.
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spelling doaj.art-5ada9a13a5054e30a0c5e4a55f0a7a402023-02-06T01:40:58ZengHindawi LimitedCase Reports in Dermatological Medicine2090-64712023-01-01202310.1155/2023/7751754Systemic Sarcoidosis Presenting in a ScarAmy Xiao0Lauryn M. Falcone1Joseph C. English III2School of MedicineDepartment of DermatologyDepartment of DermatologyWhile most forms of sarcoidosis of the skin do not require treatment, 40% of patients initially diagnosed with cutaneous sarcoidosis are found to have an asymptomatic disease involving other organ systems. It is the involvement of the lungs, heart, eyes, and nervous system which most often contributes to morbidity/mortality. An early and accurate diagnosis of sarcoidosis is difficult because patients may be asymptomatic, initial presentations may vary, and there is no single reliable diagnostic test except biopsy. We present a case of scar sarcoidosis which led to the diagnosis of stage II pulmonary sarcoidosis in a woman in her 50s. Her scar sarcoidosis presented as well-circumscribed, reddish-brown macules surrounding an atrophic scar from a prior skin graft on the right leg. Biopsy revealed scattered, well-formed, non-necrotizing granulomas of the dermis composed of epithelioid histiocytes and multinucleated giant cells, surrounded by a sparse infiltrate of lymphocytes and histiocytes. A CT chest demonstrated extensive hilar lymphadenopathy, leading to a diagnosis of stage II pulmonary sarcoidosis with cutaneous involvement. This case illustrates the interesting presentation of scar sarcoidosis and underscores the importance of a broad differential including sarcoidosis for skin changes around scars and underscores the need for early biopsy. Prompt cutaneous diagnosis leads to earlier systemic evaluation, therapeutics, and better outcomes.http://dx.doi.org/10.1155/2023/7751754
spellingShingle Amy Xiao
Lauryn M. Falcone
Joseph C. English III
Systemic Sarcoidosis Presenting in a Scar
Case Reports in Dermatological Medicine
title Systemic Sarcoidosis Presenting in a Scar
title_full Systemic Sarcoidosis Presenting in a Scar
title_fullStr Systemic Sarcoidosis Presenting in a Scar
title_full_unstemmed Systemic Sarcoidosis Presenting in a Scar
title_short Systemic Sarcoidosis Presenting in a Scar
title_sort systemic sarcoidosis presenting in a scar
url http://dx.doi.org/10.1155/2023/7751754
work_keys_str_mv AT amyxiao systemicsarcoidosispresentinginascar
AT laurynmfalcone systemicsarcoidosispresentinginascar
AT josephcenglishiii systemicsarcoidosispresentinginascar