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Extensive lichenoid type of Cutaneous sarcoidosis - A case report / Ekstenzivna lihenoidna saroidoza kože

Identifieur interne : 002017 ( Istex/Curation ); précédent : 002016; suivant : 002018

Extensive lichenoid type of Cutaneous sarcoidosis - A case report / Ekstenzivna lihenoidna saroidoza kože

Auteurs : Lidija Kandolf Sekulovi [Serbie] ; Miroslav Dini [Serbie] ; Tatjana Radevi [Serbie] ; Radoš Ze Evi [Serbie] ; Lidija Zolotarevski [Serbie] ; Vukojica Karli I [Serbie]

Source :

Serbian Journal of Dermatology and Venerology [ 1821-0902 ] ; 2011.

RBID : ISTEX:523C69B2961357DBEEAF00226CEC0C682949835D

English descriptors

Teeft :
- Acad dermatol, Adult patient, Antimalarial, Consultant pulmonologist, Corticosteroid, Cutaneous, Cutaneous sarcoidosis, Dermatol, Dermatology, Dermatovenereologists, Erythematous papules, Extensive lichenoid sarcoidosis, Granuloma, Great imitators, Histopathological, Histopathological analysis, Individual lesions, Kandolf, Kandolf sekulovi, Lesion, Lichen, Lichen scrofulosorum, Lichenoid, Lichenoid appearance, Lichenoid sarcoidosis, Lung tissue, Lupus pernio, Mycobacterium, Mycobacterium tuberculosis, Noncaseating, Normal limits, Papular, Papule, Periorbital region, Personal history, Propionibacterium acnes, Pulmonary tuberculosis, Sarcoid, Sarcoidosis, Sarcoidosis patients, Sarkoidoze, Scar sarcoidosis, Scrofulosorum, Serbian, Serbian association, Skin biopsy, Skin lesions, Transbronchial biopsy, Venereology, Whitish scales.

Abstract

Cutaneous manifestations of sarcoidosis are present in up to 25% of patients. The manifestatons can be very variable, making this disease one of the „great imitators“ in dermatology. One of its clinical variants is lichenoid sarcoidosis, which is more commonly described in children. We report an adult patient with extensive lichenoid sarcoidosis with a personal history of treated pulmonary tuberculosis, without any evidence of actual pulmonary involvement with sarcoidosis. The main differential diagnosis of lichenoid sarcoidosis of lichen scrofulosorum, so thorough examinations, to exclude active tuberculosis, are essential in theses cases. The patient was succesfully treated with antimalarial drugs, and lowdose systemic corticosteroids.

Uvod: Sarkoidoza se na koži javlja kod 25% obolelih, a njene različite kliničke manifestacije čine je jednim od največih imitatora u dermatologiji. Jedna od varijanti kutane sarkoidoze je lihenoidna, koja se češće opisuje kod dece. Prikazujemo odraslog pacijenta sa lihenoidnom varijantom kutane sarkoidoze, sa generalizovanim promenama, uspešno lečenim antimalarikom i niskim dozama sistemskih kortikosteroida. Prikaz slučaja: Muškarac starosti 53 godine, pre 20 godina lečen zbog plućne tuberkuloze, hospitalizovan je zbog brojnih generalizovanih zagasito eritematoznih glatkih papula sa beličastom skvamom, lihenoidnog izgleda, grupisanih na trupu, gornjim i donjim ekstremiteta. Promene na koži su se javile godinu dana pre hospitalizacije, a lečen je bez uspeha topijskim kortikosteroidima.Histopatološkom analizom uzorka kože postavljena je dijagnoza kutane sarkoidoze. Na osnovu laboratorijskih analiza, radioloških pretraga i histopatološkim analizama transbronhijalne biopsije pluća, isključena je aktivna tuberkuloza pluća, a nije dokazana ni sarkoidoza pluća. Započeto je lečenje hlorokvinom 250 mg/d, uz depo preparat kortikosteroida, što je dovelo do povlačenja promena na koži. Zaključak: Glavna diferencijalna dijagnoza lihenoidne sarkoidoze je lichen scrofulosorum, zbog čega je neophodno pre započinjanja lečenja isključiti tuberkuloznu etiologiju promena na koži. Antimalarici sa niskim dozama ili bez niskih doza sistemskih kortikosteroida predstavljaju terapiju prvog izbora kod generalizovanih promena u kutanoj sarkoidozi.

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https://api.istex.fr/ark:/67375/QT4-251LS5H0-3/fulltext.pdf

DOI: 10.2478/v10249-011-0034-8

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<front><div type="abstract" xml:lang="en">Cutaneous manifestations of sarcoidosis are present in up to 25% of patients. The manifestatons can be very variable, making this disease one of the „great imitators“ in dermatology. One of its clinical variants is lichenoid sarcoidosis, which is more commonly described in children. We report an adult patient with extensive lichenoid sarcoidosis with a personal history of treated pulmonary tuberculosis, without any evidence of actual pulmonary involvement with sarcoidosis. The main differential diagnosis of lichenoid sarcoidosis of lichen scrofulosorum, so thorough examinations, to exclude active tuberculosis, are essential in theses cases. The patient was succesfully treated with antimalarial drugs, and lowdose systemic corticosteroids.</div>
<div type="abstract" xml:lang="sr">Uvod: Sarkoidoza se na koži javlja kod 25% obolelih, a njene različite kliničke manifestacije čine je jednim od največih imitatora u dermatologiji. Jedna od varijanti kutane sarkoidoze je lihenoidna, koja se češće opisuje kod dece. Prikazujemo odraslog pacijenta sa lihenoidnom varijantom kutane sarkoidoze, sa generalizovanim promenama, uspešno lečenim antimalarikom i niskim dozama sistemskih kortikosteroida. Prikaz slučaja: Muškarac starosti 53 godine, pre 20 godina lečen zbog plućne tuberkuloze, hospitalizovan je zbog brojnih generalizovanih zagasito eritematoznih glatkih papula sa beličastom skvamom, lihenoidnog izgleda, grupisanih na trupu, gornjim i donjim ekstremiteta. Promene na koži su se javile godinu dana pre hospitalizacije, a lečen je bez uspeha topijskim kortikosteroidima.Histopatološkom analizom uzorka kože postavljena je dijagnoza kutane sarkoidoze. Na osnovu laboratorijskih analiza, radioloških pretraga i histopatološkim analizama transbronhijalne biopsije pluća, isključena je aktivna tuberkuloza pluća, a nije dokazana ni sarkoidoza pluća. Započeto je lečenje hlorokvinom 250 mg/d, uz depo preparat kortikosteroida, što je dovelo do povlačenja promena na koži. Zaključak: Glavna diferencijalna dijagnoza lihenoidne sarkoidoze je lichen scrofulosorum, zbog čega je neophodno pre započinjanja lečenja isključiti tuberkuloznu etiologiju promena na koži. Antimalarici sa niskim dozama ili bez niskih doza sistemskih kortikosteroida predstavljaju terapiju prvog izbora kod generalizovanih promena u kutanoj sarkoidozi.</div>
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Extensive lichenoid type of Cutaneous sarcoidosis - A case report / Ekstenzivna lihenoidna saroidoza kože

Extensive lichenoid type of Cutaneous sarcoidosis - A case report / Ekstenzivna lihenoidna saroidoza kože

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Abstract

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