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   Abstract
   Introduction
   Case Reports
   Discussion
   References

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CASE REPORTS
Year : 2000  |  Volume : 66  |  Issue : 2  |  Page : 97-98

Sarcoidosis



Correspondence Address:
Rit Jaiswal


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Source of Support: None, Conflict of Interest: None


PMID: 20877041

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  Abstract 

Two cases of cutaneous sarcoidosis with itchy lesions are reported. Both patients had systemic involvement and were successfully treated with glucocorticoids


Keywords: Sarcoidosis, Itching


How to cite this article:
Jaiswal R. Sarcoidosis. Indian J Dermatol Venereol Leprol 2000;66:97-8

How to cite this URL:
Jaiswal R. Sarcoidosis. Indian J Dermatol Venereol Leprol [serial online] 2000 [cited 2019 Aug 24];66:97-8. Available from: http://www.ijdvl.com/text.asp?2000/66/2/97/4883



  Introduction Top


Sarcoidosis is a multisystem granulomatous disease of unknown aetiology characterized by non caseating epitheloid cell granuloma. [1],[2] Cutaneous manifestations of sarcoidosis are seen in 20-35% of patients with systemic disease. [1] However disease may be limited to skin without any organ involvement for years. [3] Cutaneous sarcoidosis affects females predominantly. [4] Sarcoidosis is considered as a rare disease in India and only 300 cases have been re­ported till 1986. [5]


  Case Reports Top


Case 1

A 30-year-old woman presented with erythematous raised lesions over face of 6 months duration. Lesions were mildly pruritic. Except history of breathlesness the general health was well preserved. On examination there were erythematous papular-and papulonodular lesions over face and a few lesions over lower back. Lesions were quite firm on palpation. X-ray chest revealed bilateral hilar lymphadenopathy with a few nodular opacities in both the lung fields. Mantoux test was negative. Sputum for AFB was negative. Pulmonary function test revealed mild obstructive lung disease on spiromertry. Complete blood count and hepatic and renal function tests were normal. S. calcium was 9 mg%. A biopsy from one of the lesions showed compact epitheloid cell granuloma with occasional giant cell and a lympho-mononuclear infiltrate. Patient was treated with short course of prednisolone starting with 40mg daily and tapered gradually in 8 weeks. All lesions disappeared in 3 weeks of treatment with gradual improvement of breathlessness.

Case 2

A 65-year-old lady presented with itchy raised lesions over face and right forearm. There was no history of fever, breathlessness, cough or sputum. On examination 3 papuloplaque lesions were present over face which showed comedone formation at the periphery of lesions. A single indurated erythematous plaque lesion was present on right forearm without any loss of sensation. Patient was severely anaemic (Hb-8gm). There was leukocytosis. Hepatic and renal function tests were normal. S. calcium was 9.4 mg%. Sputum for AFB and Mantoux test were negative. X­ray chest showed bilateral hilar lymphadenopathy with parahilar calcification. A biopsy from forearm lesion showed epitheloid cell granuloma with Langhans giant cells and lymphocytic infiltrate in the dermis. Lesions disappeared with twice daily application of betamethasone dipropionate 0.05% for 4 weeks.


  Discussion Top


Papular lesions of cutaneous sarcoidosis are non-specific clinically except a degree of induration which is classically present in all the lesions of sarcoidosis. A high degree of suspicion is required to clinch the diagnosis. The present patients had lesions which were quite non-specific and combined with itching could have misled the unwary. Itching has so far not described in sarcoidosis to the best of our knowledge. Systemic features were typical of sarcoidosis in these patients. In india where other granulomatous diseases like leprosy and tuberculosis are so common, sarcoidosis is probably underdiagnosed due to lack of index of suspicion for this disease.







 
  References Top

1.Savin J A. Sarcoidosis of the skin. In : Textbook of Dermatology Champion RH. Burton IL, Ebling FIG. eds. 5th edn. oxford : Blackwell Scientific Publications. 1992; 2383-2406.  Back to cited text no. 1    
2.Lever WF, Schaumburg-Lever G. Histopathology of the Skin, 6th edn. philadelphia: JB Lippincott Company 1933;229-233.  Back to cited text no. 2    
3.Hanno R. Needelman A, Eiferman RA, et al. Cutaneous sarcoidal granulomas and development of systemic sarcoidosis. Arch Dermatol 1981; 117: 203-207.  Back to cited text no. 3    
4.Hames DG. Dermatological aspects of sarcoidosis. Quart J Med 1959; 28: 109.  Back to cited text no. 4    
5.Gupt SK. Sarcoidosis in India, the past, present and future. Lung India 1987; 5;101-105.  Back to cited text no. 5    




 

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