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LETTER TO EDITOR
Year : 1996  |  Volume : 62  |  Issue : 4  |  Page : 273-274

Cutaneous sarcoidosis without systemic involvement : response to intralesional corticosteroid




Correspondence Address:
S K Singh


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Source of Support: None, Conflict of Interest: None


PMID: 20948088

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How to cite this article:
Singh S K, Singh S, Pandey S S. Cutaneous sarcoidosis without systemic involvement : response to intralesional corticosteroid. Indian J Dermatol Venereol Leprol 1996;62:273-4

How to cite this URL:
Singh S K, Singh S, Pandey S S. Cutaneous sarcoidosis without systemic involvement : response to intralesional corticosteroid. Indian J Dermatol Venereol Leprol [serial online] 1996 [cited 2019 Sep 17];62:273-4. Available from: http://www.ijdvl.com/text.asp?1996/62/4/273/4425



  To the Editor, Top


A 39-year-old male patient presented with mildly itchy, slowly progressive, purplish red, papular and nodular lesions mainly on the upper part of chest and extensor aspect of right arm, and a few lesions over the nape of neck and medial canthus of the right eye for past 3 years. There was no history of fever, cough, breathlessness, weight loss or night sweats. General and systemic examinations revealed no abnormality. Examination of the skin showed purplish red papules and nodules. Few lesions had coalesed to form plaques of 3-4 cm in diameter. Following investigations were negative or within normal limits : total leucocyte count, liver function tests, serum calcium, VDRL test, slit skin smear for acid fast bacilli and Leishman Donovan bodies, slit lamp examination of eyes, routine urine and stool examinations, X-ray of skull, hands and chest, pulmonary function tests. Differential leucocyte count showed mild eosinophilia, erythrocyte sedimentation rate was 36 mm in first hour (Westergren method). Mantoux test with 2 tuberculin units was negative (erythema 2 mm, induration nil). Biopsy of a lesion showed noncaseating epithelioid cell granulomas in the dermis with no evidence of any infective organism. The patient was diagnosed as a case of cutaneous sarcoidosis without systemic involvement.

Treatment was begun with intralesional injection of triamcinolone acetonide (40 mg/ml) in half dilution once a month. After the first injections, there was marked improvement with reduction in erythema and thickness of the lesions, smaller lesions subsided completely. After receiving 3 courses of injections, most of the lesions subsided considerably.

Cutaneous sarcoidosis has been rarely reported from India.[1][2][3][4] However, in none of these reports sarcoidosis spontaneously occurred and remained confined to the skin. The possibility that other organ systems may get involved in future in our patient cannot be ruled out. The response to intralesional injection of corticosteroid was encouraging in our patient and this form of therapy may be considered in cutaneous sarcoidosis.

 
  References Top

1.Rajam RV, Vishwanathan GS, Rangiah VN, Anguli VC. Sarcoidosis. A short review with a case report. Ind J Dermatol Venereol 1957;23:95-135.  Back to cited text no. 1    
2.Gupta SK. Sarcoidosis in India : long term follow up report of a series. J Assoc Physicians India 1982;30:304-8.  Back to cited text no. 2  [PUBMED]  
3.Bajaj AK, Lai M, Gupta SC, Dwivedi SC, Shukla SK. Sarcoidosis. Ind J Dermatol Venereol Leprol 1979;45:459-62.  Back to cited text no. 3    
4.Sarkar TK. Sarcoidosis diagnosed by biopsy of the scar. J Ind Med Assoc 1967;48:20-30.  Back to cited text no. 4  [PUBMED]  




 

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