Sarcoidosis

Abstract

Sarcoidosis is a systemic granulomatous disease of unknown cause that most commonly affects the lungs, lymph nodes, skin, eyes, spleen, bone, and glandular tissue. The diagnosis is made when characteristic histologic findings are demonstrated and other granulomatous processes are excluded. It can be an acute or chronic debilitating disease, but in patients with acute disease the process can be self-limited. Multiple therapeutic options have been described both for the cutaneous and systemic lesions of sarcoidosis. Steroids, however, remain the cornerstone of therapy.

Lupus Pernio

“…Dermatologic manifestations of sarcoidosis are divided into two groups: specific (yielding, non-caseating granulomas on histopathology) and non-specific (reactive). Sarcoid skin disease generally has no prognostic significance and no correlation with the likelihood of systemic involvement (4). Two notable exceptions are erythema nodosum (EN) and lupus pernio.…”

“…Erythema nodosum is the most common of the non-specific lesions and is the hallmark of acute, benign and self-limited disease (5,6). Lupus pernio is sarcoid-specific and is most common in African-American women (4). It has a high predictive value for both pulmonary parenchymal involvement and involvement of the nasal and oral mucosa, larynx and pharynx, salivary glands, tongue, and tonsils.…”

Sarcoidosis

“…Lupus pernio ve eritema nodozum dışındaki deri lezyonlarının prognostik bir anlamı olmadığı, sistemik hastalığın yaygın-lığıyla bir korelasyon göstermediği bilinmektedir. Eritema nodozum iyi prognozu gösteren bir deri bulgusuyken, lupus pernio kronik hastalık habercisidir (17).…”

“…Sıklıkla sarkoidozun akut döneminde ortaya çıkar ve iyi prognozla ilişkilidir (17). Daha nadir görülen nonspesifik deri lezyonları; edinsel iktiyoz, eritema multiforme, eritrodermi, pruritus, kalsifikasyonlar ve Sweet sendromudur (1).…”

Medium-dose-UV-A1-Phototherapie

“…Einige dieser Granulome enthalten auch Riesenzellen.Um die Epitheloidzelle sind meistens CD4-positive T-Zellen angeordnet, ferner finden sich auch CD8-positive Supressor-zytotoxische T-Zellen [5]. Alle diese Befunde deuten darauf hin,dass die Sarkoidose durch eine zelluläre Immunantwort aufgrund persistierender spezifischer Antigene hervorgerufen wird [9,11].…”