Sarcoidosis

Gawkrodger, David J.

doi:10.1002/9780470750520.ch58

Cited by 19 publications

(29 citation statements)

References 159 publications

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“…The limited form, characterized by no renal involvement, has a favorable prognosis and accounts for 70% of cases 4 . The onset of WG is usually between 25 and 55 years of age, but may occur at any age, affecting patients of less than 19 years of age in 15% of cases 5,6 …”

Section: Discussionmentioning

confidence: 99%

Cutaneous sarcoid‐like granulomas with alveolar hemorrhage and c‐ANCA PR‐3

et al. 2004

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A 28‐year‐old woman, employed as a leather factory worker, noted asymptomatic, well‐delimited plaques on both knees, 6 years ago. The plaques were violaceous with a smooth surface. One appeared over a post‐traumatic scar from childhood (Fig. 1). Two years later, she began to complain of symptoms suggestive of polyarthritis, first of the small joints of the hands (proximal interphalanges) and then of the larger joints (wrists, elbows, and knees). She was diagnosed with rheumatoid arthritis and began treatment with nonsteroidal anti‐inflammatory drugs for 1 month without any change. Deflazacort, 12 mg/day, and hydroxychloroquine, 400 mg/day, were administered for 3 months, with improvement of her articular complaints, but not her skin lesions. 1 Well‐delimited, violaceous plaques with a smooth surface on the knees, one over an old post‐traumatic scar One year later, she complained of dysphonia, which remitted spontaneously after some weeks. After one additional year, she noted papules, with similar characteristics to the plaques, on the elbows, and two well‐delimited orange‐to‐brown plaques on the forehead (Fig. 2). 2 Orange–brown plaques symmetrically placed on the forehead During the fifth year of the disease, she was referred for the first time to a dermatologist, who biopsied one of the knee lesions. The histologic result was compatible with “sarcoid granuloma.” At that time, she presented with skin lesions as her only complaint. Sarcoidosis was suspected based on a chest X‐ray, which revealed hilar lymphadenopathy and diffuse accentuation of the interstitium. In November 2000, she suddenly developed fever (40 °C), cough with hemoptysis, dysphonia, and subcutaneous nodules on the palmar surface of the fingers of both hands that were painless, well‐delimited, 5 mm in diameter, and firm (Fig. 3). She reported a weight loss of 12 kg in the previous 3 months. Pulmonary condensation was found on auscultation, and she had palpable hepatomegaly. Peripheral lymphadenopathy was not present. 3 Painless, well‐delimited, firm subcutaneous nodules on the palmar surface of the fingers Laboratory investigations revealed normochromic, normocytic anemia (hemoglobin, 7.7 g/dL), iron deficit, a white blood cell count of 16,000/µL with neutrophilia, an erythrocyte sedimentation rate of 130 mm/h, elevation of liver enzymes, a slight increase in angiotensin‐converting enzyme (ACE) level (72 U/L), hypergammaglobulinemia (IgG, 3350 mg/dL), antinuclear antibody (ANA) of 1 : 320, and a slight increase in CD4 and decrease in CD8 lymphocytes with normal cellular morphology in blood. Renal function, urine sediment, urine and serum calcium, complement (C4), dsDNA, antimitochondrial antibody, direct and indirect Coombs test, antineutrophil cytoplasmic antibody (ANCA), tuberculin skin tests, viral markers of hepatitis B, C, and human immunodeficiency virus (HIV), electrocardiogram (ECG), ophthalmic examinations, and culture for infectious agents in blood and sputum were all normal or negative. Computed tomography (CT) scan showed an ...

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Section: Discussionmentioning

confidence: 99%

Cutaneous sarcoid‐like granulomas with alveolar hemorrhage and c‐ANCA PR‐3

et al. 2004

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“…Synonyms include encapsulated necrosis (Kikuchi) 2 and encapsulated fat necrosis 3 . Herein, we report nodular cystic fat necrosis in a patient with uveitis and facial nerve palsy associated with sarcoidosis (Heerfordt's syndrome) 4 …”

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confidence: 95%

“…Cardiac involvement was not observed. The patient was diagnosed as having Heerfordt's syndrome, 4 a clinical subtype of sarcoidosis.…”

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confidence: 99%

Nodular cystic fat necrosis in Heerfordt's syndrome

Ueda

Satoh

Yamamoto

et al. 2007

Acad Dermatol Venereol

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“…The histologic differentiation of sarcoidosis from lupus vulgaris is very difficult, if not impossible 1,3 . A therapeutic trial of ATT may be the only solution 6 …”

Section: Discussionmentioning

confidence: 99%

“…A therapeutic trial of ATT is worth trying in difficult cases where definitive diagnosis is not forthcoming despite the potential adverse effects of ATT 1,6,12 . Hence, empiric treatment after taking into consideration the entire clinical setting may be the only option left with the clinician faced with this complex if not daunting clinical entity.…”

Section: Discussionmentioning

confidence: 99%

Atypical forms of lupus vulgaris – a case series

et al. 2009

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Atypical presentations of cutaneous tuberculosis are not so uncommon and are frequently overlooked in clinical practice, leading to late diagnosis and increased morbidity. We report three cases of lupus vulgaris with atypical presentations. The cases mimicked other chronic skin lesions like actinomycosis, mycetoma, and so on. Strong clinical suspicion, histopathology, and response to antituberculous treatment led to the diagnosis and all three had excellent response to treatment. Today, when tuberculosis threatens to burst into pandemics again, early diagnosis and treatment are more important than ever for control and prevention of morbidity.

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Sarcoidosis

Cited by 19 publications

References 159 publications

Cutaneous sarcoid‐like granulomas with alveolar hemorrhage and c‐ANCA PR‐3

Cutaneous sarcoid‐like granulomas with alveolar hemorrhage and c‐ANCA PR‐3

Nodular cystic fat necrosis in Heerfordt's syndrome

Atypical forms of lupus vulgaris – a case series

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