Epidemiological, Clinical, and Paraclinic Aspect of Cutaneous Sarcoidosis in Black Africans

Abstract

The specific objectives were to identify the epidemiology of cutaneous sarcoidosis and describe the clinical and laboratory aspects of the disease. Materials and Methods. We performed a descriptive cross-sectional study involving 24 referred cases of cutaneous sarcoidosis in 25 years (1990–2014) collected at Venereology Dermatology Department of the University Hospital of Treichville (Abidjan) both in consultation and in hospitalization. Results. The hospital frequency was one case per year. The average age was 42 years, ranging from 9 to 64. The sex ratio was 1. The shortest time interval between the appearance of the skin lesion and consultation of Dermatology Department at CHU Treichville was 3 months. The elementary lesions were represented primarily by a papule (18 cases), placard (3 cases), and nodule (2 cases) and mainly sat on the face and neck in 8 cases (38%). Extra cutaneous lesions were dominated by ganglion and respiratory involvement with 5 cases each followed by musculoskeletal damage in 3 cases. Chest radiography showed abnormality in 13 cases (54%). The pulmonary function test performed in 13 patients found 7 cases (54%) having restrictive ventilatory syndrome and 6 cases (46%) being normal. A tuberculin anergy was found in 11 cases (61%).

Dermatology in black skin

“…Lupus pernio is associated with a worse prognosis for both systemic disease and more chronic skin lesions. 77 , 78 Black people have sarcoidosis at a younger age, on average around the 40 s, and women more so than men. Most of the time, the initial lesions are asymptomatic, with the first consultation being motivated by disfigurement.…”

“…Mortality rates are higher. 77 , 78 Lupus pernio is associated with a worse prognosis for both systemic disease and more chronic skin lesions. 7…”

The position of geochemical variables as causal co-factors of diseases of unknown aetiology

“…Sarcoidosis in not a rare condition in Africa (Awotedu et al, 1987;Kaloga et al, 2015), the apparent infrequency of reporting being probably a result of misdiagnosis (as, e.g., tuberculosis) (Morar and Feldman, 2015a;Morar and Feldman, 2015b). Further research is therefore necessary in Africa to unravel the various clinical aspects of this mysterious and complex disease Exposure to toxic metals and rare earth elements (REEs) in the environment - Newman, 1998;Beijer et al, 2020;Denisova et al, 2020;Metal dusts -Judson, 2020;Crystalline silica -Arkema and Cozier, 2018; Industrial exposure to Be - Culver et al, 2007. Since low dose metal particles can induce monocyte/macrophage survival (See e.g., Lacey et al, 2009), as recently as 2021, Lepzien et al (2021) went on to show that monocytes could be a vital marker in understanding the inflammatory process of sarcoidosis.…”

The position of geochemical variables as causal co-factors of diseases of unknown aetiology

“…Race and geographical location are considered as factors in the incidence and prevalence of sarcoidosis, which has consistently been observed to be highest in Nordic countries and in African Americans—[ 231 ]. Sarcoidosis in not a rare condition in Africa—[ 232 , 233 ], the apparent infrequency of reporting being probably a result of misdiagnosis (as, e.g., tuberculosis)—[ 234 , 235 ]. Further research is therefore necessary in Africa to unravel the various clinical aspects of this mysterious and complex disease Exposure to toxic metals and rare earth elements (REEs) in the environment—[ 236 – 238 ]; Metal dusts—[ 239 ]; Crystalline silica—[ 231 ]; Industrial exposure to Be—[ 240 ] Since low dose metal particles can induce monocyte / macrophage survival (See e.g., Lacey et al—[ 241 ]), as recently as 2021, Lepzien et al—[ 242 ] went on to show that monocytes could be a vital marker in understanding the inflammatory process of sarcoidosis Geographic clustering of disease in many parts of the world has long been noted, [e.g., in the US (Sartwell and Edwards—[ 243 ]); this (clustering) has ignited further speculations concerning weather, soil, and foliage in the pathogenesis of sarcoidosis.…”