Seltene ulzerierende kutane und systemische Sarkoidose

Abstract

Sarcoidosis is a granulomatous multisystemic disease of unclear etiology, which can affect any organ. The cutaneous manifestations are variable, but ulcerative cutaneous sarcoidosis is very rare. One must rule out other granulomatous skin diseases, especially necrobiosis lipoidica. There is no standarized therapy; usually an interdisciplinary approach over years taking multiple side effects into consideration is needed. A 58-year-old woman with a long history of cutaneous, nodal and pulmonary sarcoidosis suddenly developed ulcerations within the disseminated skin lesions on her legs. The combination of systemic hydroxychloroquine and modern wound management lead to complete healing of the ulcers and a significant improvement in the remaining skin lesions.

Nonsteroidal therapy of sarcoidosis

“…There are no new data from clinical trials that evaluated the use of hydroxychloroquine, but case reports suggest that treatment might be most useful for cutaneous manifestations [25,26]. …”

Kompressionstherapie bei entzündlichen Dermatosen der Beine

“…Bei 52 % der Patienten heilte die Wunde vollständig ab; insgesamt 71 % der Patienten konnten ein Selbstmanagement durchführen [27]. Es finden sich weitere Fallberichte zu entzündlichen Dermatosen der Beine bei den Diagnosen Erythema induratum [28], Erythema nodosum [29], Perifolliculitis capitis abscedens et suffodiens [30], Purpura pigmentosa progressiva [31], ulzerierende kutane Sarkoidose [32] und ulzerierende Morphea [33], die von einer Kompressionstherapie profitiert haben.…”