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Epidemiology of cutaneous sarcoidosis, 1976–2013: a population‐based study from Olmsted County, Minnesota

Identifieur interne : 000B75 ( Istex/Corpus ); précédent : 000B74; suivant : 000B76

Epidemiology of cutaneous sarcoidosis, 1976–2013: a population‐based study from Olmsted County, Minnesota

Auteurs : P. Ungprasert ; D. A. Wetter ; C. S. Crowson ; E. L. Matteson

Source :

RBID : ISTEX:ACCC5804FFBF78BC8890F975DBF09145DD0EA6BF

Abstract

Background: The epidemiology of cutaneous sarcoidosis is not well‐characterized as only referral‐based studies are available. Objectives: To characterize the epidemiology of cutaneous sarcoidosis, with emphasis on annual incidence and clinical characteristics, from 1976 to 2013. Methods: Inception cohorts of patients with incident isolated cutaneous sarcoidosis and incident systemic sarcoidosis with cutaneous involvement in 1976–2013 in Olmsted County, Minnesota, United States were identified based on comprehensive individual medical record review. Inclusion in the isolated cutaneous sarcoidosis cohort required physician diagnosis and skin biopsy showing non‐necrotizing granuloma. Inclusion in the systemic sarcoidosis with cutaneous involvement cohort required presence of systemic sarcoidosis and cutaneous lesions. Presence of systemic sarcoidosis was determined by physician diagnosis supported by histopathology of non‐necrotizing granuloma, characteristic radiologic features of intrathoracic sarcoidosis and exclusion of other granulomatous diseases. Cutaneous lesions were defined as either sarcoidosis‐specific or non‐specific. Results: There were 62 cases with sarcoidosis‐specific cutaneous lesions (36 cases of sarcoidosis‐specific cutaneous lesions and 26 cases of isolated cutaneous sarcoidosis) which corresponded to an incidence of 1.9 per 100 000 population. The female to male ratio was 2.1 : 1. Plaques, papules and subcutaneous nodules were the most commonly observed cutaneous lesions. There was no significant difference in cutaneous presentation between those who had isolated skin disease and those who had skin disease in association with systemic sarcoidosis. Prognosis of cutaneous sarcoidosis was favourable, as over 90% of patients had a good response to either glucocorticoids, hydroxychloroquine or tetracycline antibiotics. This study has a significant limitation, in that the studied population was predominantly Caucasians who generally have a lower prevalence of skin disease. Conclusions: The incidence of sarcoidosis‐specific cutaneous lesions was about 1.9 per 100 000 population with female predominance. The cutaneous presentations were similar among those with and without systemic sarcoidosis.

Url:
DOI: 10.1111/jdv.13760

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ISTEX:ACCC5804FFBF78BC8890F975DBF09145DD0EA6BF

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<title sort="JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY" type="main">Journal of the European Academy of Dermatology and Venereology</title>
<title type="short">J Eur Acad Dermatol Venereol</title>
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<doi origin="wiley">10.1111/jdv.2016.30.issue-10</doi>
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<title type="articleCategory">Short Report</title>
<title type="tocHeading1">INFLAMMATORY SKIN DISEASES</title>
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<copyright ownership="thirdParty">© 2016 European Academy of Dermatology and Venereology</copyright>
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<correspondenceTo>Correspondence: P. Ungprasert. E‐mails:
<email>P.Ungprasert@gmail.com</email>
;
<email>Ungprasert.Patompong@mayo.edu</email>
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<title type="main">Epidemiology of cutaneous sarcoidosis, 1976–2013: a population‐based study from Olmsted County, Minnesota</title>
<title type="shortAuthors">Ungprasert
<i>et al</i>
.</title>
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<orgName>Department of Internal Medicine Mayo Clinic College of Medicine</orgName>
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<orgDiv>Division of Biomedical Statistics and Informatics</orgDiv>
<orgDiv>Department of Health Sciences Research</orgDiv>
<orgName>Mayo Clinic College of Medicine</orgName>
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<city>Rochester</city>
<countryPart>MN</countryPart>
<country>USA</country>
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<orgDiv>Division of Epidemiology</orgDiv>
<orgDiv>Department of Health Sciences Research</orgDiv>
<orgName>Mayo Clinic College of Medicine</orgName>
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<city>Rochester</city>
<countryPart>MN</countryPart>
<country>USA</country>
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<fundingAgency fundRefName="National Institute on Aging" funderDoi="10.13039/100000049">National Institute on Aging of the National Institutes of Health</fundingAgency>
<fundingNumber>R01 AG034676</fundingNumber>
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<fundingAgency>CTSA</fundingAgency>
<fundingNumber>UL1 TR000135</fundingNumber>
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<title type="main">Abstract</title>
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<title type="main">Background</title>
<p>The epidemiology of cutaneous sarcoidosis is not well‐characterized as only referral‐based studies are available.</p>
</section>
<section xml:id="jdv13760-sec-0002">
<title type="main">Objectives</title>
<p>To characterize the epidemiology of cutaneous sarcoidosis, with emphasis on annual incidence and clinical characteristics, from 1976 to 2013.</p>
</section>
<section xml:id="jdv13760-sec-0003">
<title type="main">Methods</title>
<p>Inception cohorts of patients with incident isolated cutaneous sarcoidosis and incident systemic sarcoidosis with cutaneous involvement in 1976–2013 in Olmsted County, Minnesota, United States were identified based on comprehensive individual medical record review. Inclusion in the isolated cutaneous sarcoidosis cohort required physician diagnosis and skin biopsy showing non‐necrotizing granuloma. Inclusion in the systemic sarcoidosis with cutaneous involvement cohort required presence of systemic sarcoidosis and cutaneous lesions. Presence of systemic sarcoidosis was determined by physician diagnosis supported by histopathology of non‐necrotizing granuloma, characteristic radiologic features of intrathoracic sarcoidosis and exclusion of other granulomatous diseases. Cutaneous lesions were defined as either sarcoidosis‐specific or non‐specific.</p>
</section>
<section xml:id="jdv13760-sec-0004">
<title type="main">Results</title>
<p>There were 62 cases with sarcoidosis‐specific cutaneous lesions (36 cases of sarcoidosis‐specific cutaneous lesions and 26 cases of isolated cutaneous sarcoidosis) which corresponded to an incidence of 1.9 per 100 000 population. The female to male ratio was 2.1 : 1. Plaques, papules and subcutaneous nodules were the most commonly observed cutaneous lesions. There was no significant difference in cutaneous presentation between those who had isolated skin disease and those who had skin disease in association with systemic sarcoidosis. Prognosis of cutaneous sarcoidosis was favourable, as over 90% of patients had a good response to either glucocorticoids, hydroxychloroquine or tetracycline antibiotics. This study has a significant limitation, in that the studied population was predominantly Caucasians who generally have a lower prevalence of skin disease.</p>
</section>
<section xml:id="jdv13760-sec-0005">
<title type="main">Conclusions</title>
<p>The incidence of sarcoidosis‐specific cutaneous lesions was about 1.9 per 100 000 population with female predominance. The cutaneous presentations were similar among those with and without systemic sarcoidosis.</p>
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<p>
<b>Conflicts of interest</b>
</p>
<p>We do not have any financial or non‐financial potential conflicts of interest.</p>
</note>
<note numbered="no" xml:id="jdv13760-note-1002">
<p>
<b>Funding sources</b>
</p>
<p>This study was made possible using the resources of the Rochester Epidemiology Project, which is supported by the National Institute on Aging of the National Institutes of Health under Award Number R01 AG034676, and CTSA Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences, NCATS, a component of the National Institutes of Health (NIH). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.</p>
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<abstract>Background: The epidemiology of cutaneous sarcoidosis is not well‐characterized as only referral‐based studies are available. Objectives: To characterize the epidemiology of cutaneous sarcoidosis, with emphasis on annual incidence and clinical characteristics, from 1976 to 2013. Methods: Inception cohorts of patients with incident isolated cutaneous sarcoidosis and incident systemic sarcoidosis with cutaneous involvement in 1976–2013 in Olmsted County, Minnesota, United States were identified based on comprehensive individual medical record review. Inclusion in the isolated cutaneous sarcoidosis cohort required physician diagnosis and skin biopsy showing non‐necrotizing granuloma. Inclusion in the systemic sarcoidosis with cutaneous involvement cohort required presence of systemic sarcoidosis and cutaneous lesions. Presence of systemic sarcoidosis was determined by physician diagnosis supported by histopathology of non‐necrotizing granuloma, characteristic radiologic features of intrathoracic sarcoidosis and exclusion of other granulomatous diseases. Cutaneous lesions were defined as either sarcoidosis‐specific or non‐specific. Results: There were 62 cases with sarcoidosis‐specific cutaneous lesions (36 cases of sarcoidosis‐specific cutaneous lesions and 26 cases of isolated cutaneous sarcoidosis) which corresponded to an incidence of 1.9 per 100 000 population. The female to male ratio was 2.1 : 1. Plaques, papules and subcutaneous nodules were the most commonly observed cutaneous lesions. There was no significant difference in cutaneous presentation between those who had isolated skin disease and those who had skin disease in association with systemic sarcoidosis. Prognosis of cutaneous sarcoidosis was favourable, as over 90% of patients had a good response to either glucocorticoids, hydroxychloroquine or tetracycline antibiotics. This study has a significant limitation, in that the studied population was predominantly Caucasians who generally have a lower prevalence of skin disease. Conclusions: The incidence of sarcoidosis‐specific cutaneous lesions was about 1.9 per 100 000 population with female predominance. The cutaneous presentations were similar among those with and without systemic sarcoidosis.</abstract>
<note type="funding">National Institute on Aging of the National Institutes of Health - No. R01 AG034676; </note>
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