Summary
Background and Design: Sarcoidosis is a multisystem disorder of unknown etiology, characterized by noncaseating granulomas involving especially the lungs, reticuloendothelial system, eyes and skin. Although skin involvement has been reported in 9-37% of patients with sarcoidosis, isolated skin involvement has been reported in only 5.4%-13.8% of the cases. The purpose of this retrospective study was to evaluate the clinical and histopathological characteristics of patients with sarcoidosis and the relationship of cutaneous sarcoidosis with systemic sarcoidosis.
Materials and Methods: Case records and histopathological files of 27 patients who were diagnosed with cutaneous sarcoidosis in our Dermatology and Venereology Department from 2005 to 2011 were retrospectively reviewed.
Results: A total of 27 patients (22 female and 5 male) with a mean age 45 (12-69) years were evaluated. The mean duration of the disease was 1.5 years (1 month to 5 years). In 30% of patients, only skin lesions were found, and 19 patients (70%) had extracutaneous involvement. The distribution of specific types of skin lesions was plaque (12), nodules (10), papules (6), lupus pernio (4) and maculopapular rashes (1). The most common localization of the lesions was the head and neck region. One patient had an erythema nodosum lesion. Topical and systemic corticosteroids were used in eight patients with isolated skin lesions. Systemic, topical and intralesional corticosteroids and methotrexate were used in patients with extracutaneous involvement. In most of the patients, skin lesions were improved within 2-years follow-up period. Relapse was observed in 33% of patients.
Conclusion: Cutaneous involvement can occur as the first sign of a systemic disease. According to our study results, 30% of our cases were characterized with isolated skin involvement. The signs of a systemic disease may accompany cutaneous sarcoidosis. Therefore, all patients presenting to the dermatology departments with cutaneous sarcoidosis require investigations for systemic sarcoidosis. (Turkderm 2013; 47: 148-54)
Key Words: Cutaneous sarcoidosis, systemic sarcoidosis, noncaseating granuloma
Ozet
Amac: Sarkoidoz; nedeni bilinmeyen, nonkazeifiye granulomatoz histopatolojisi olan, ozellikle akciger, retikuloendotelyal sistem, goz ve deriyi tutan multisistemik bir hastaliktir. Tum sarkoidozlu olgularda deri tutulumu %9-37 oraninda bildirilirken, sadece deri tutulumu %5,4-13,8 arasindadir. Bu retrospektif calismada amac sarkoidozlu hastalarimizin klinikopatolojik ozelliklerini ve kutanoz sarkoidoz ile sistemik sarkoidoz arasindaki iliskiyi incelemektir.
Gerec ve Yontem: 2005-2011 tarihleri arasinda klinik ve patolojik olarak kutanoz sarkoidoz tanisi almis 27 hastanin tibbi kayitlari geriye donuk olarak incelendi.
Bulgular: Hastalarin 22'si kadin, 5'i erkekti. Yas ortalamalari 45 idi (12-69 arasi). Hastalik suresi 1 ay-5 yil (ort. 1,5 yil) arasinda degismekteydi. Hastalarin %30'unda sadece deri tutulumu, 19'unda (%70) ekstrakutanoz tutulum vardi. Sarkoidoz spesifik deri lezyon tiplerinin dagilimi plak (12), nodul (10), papul (6), lupus pernio (4), makulopapul (1) seklindeydi ve lezyonlarin en cok yerlestigi alanlar bas-boyun bolgesi idi. Bir hastada eritema nodozum (EN) vardi. Sadece deri tutulumu olan 8 hastada topikal ve sistemik kortikosteroid, ekstrakutanoz tutulumu olan hastalarda sistemik, topikal ve intralezyoner kortikosteroid, metotreksat kullanildi. Olgularimizin cogunda 2 yillik takip doneminde deri lezyonu duzelirken, %33'unde nuks gozlendi.
Sonuc: Kutanoz tutulum sistemik hastaligin ilk bulgusu olarak ortaya...