Cutaneous Sarcoidosis – Diagnostic Challenges

Sarcoidosis is a multisystemic granulomatous disease, with unknown etiology, characterized histopathologically by the development in the affected organs of some „empty” (non-caseous) granulomas. Cutaneous lesions can sometimes be the first localization of the disease. We present the case of a patie...

Full description

Saved in:
Bibliographic Details
Main Authors: Florica SANDRU, Mihai Cristian DUMITRASCU, Adelina POPA, Daniel-Vasile BALABAN, Razvan-Cosmin PETCA, Raluca Gabriela MIULESCU
Format: Article
Language:English
Published: Bucharest College of Physicians 2019-12-01
Series:Modern Medicine
Subjects:
Online Access:https://medicinamoderna.ro/wp-content/uploads/2019/12/RMM_art-11-Cutaneous-Sarcoidosis-%E2%80%93-Diagnostic-Challenges.pdf
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850145128294907904
author Florica SANDRU
Mihai Cristian DUMITRASCU
Adelina POPA
Daniel-Vasile BALABAN
Razvan-Cosmin PETCA
Raluca Gabriela MIULESCU
author_facet Florica SANDRU
Mihai Cristian DUMITRASCU
Adelina POPA
Daniel-Vasile BALABAN
Razvan-Cosmin PETCA
Raluca Gabriela MIULESCU
author_sort Florica SANDRU
collection DOAJ
description Sarcoidosis is a multisystemic granulomatous disease, with unknown etiology, characterized histopathologically by the development in the affected organs of some „empty” (non-caseous) granulomas. Cutaneous lesions can sometimes be the first localization of the disease. We present the case of a patient with known sarcoidosis and autoimmune thyroiditis, who developed a rash spread on the trunk and limbs, for which she was treated with dermatocorticoids and antihistamines, but without significant improvement. A skin biopsy was performed with histopathological examination, which revealed: at the dermal level, lympho-histiocytic infiltrates with nodular distribution, forming several granulomas, without areas of necrosis of caseification, including frequent cells with epithelioid appearance, suggestive for the diagnosis of cutaneous sarcoidosis. The patient underwent systemic cortisone therapy and hydroxychloroquine, with favorable outcome. The challenge of diagnosing this pathology is to differentiate it from a number of conditions, including: ring granuloma, cutaneous Crohn’s disease, lipoid necrosis, lupus vulgaris. To establish the diagnosis of certainty, it is necessary to correlate the clinical data with the result of the histopathological examination.
format Article
id doaj-art-96cbb7ad2e284cfabc5ca81a819374a4
institution OA Journals
issn 1223-0472
2360-2473
language English
publishDate 2019-12-01
publisher Bucharest College of Physicians
record_format Article
series Modern Medicine
spelling doaj-art-96cbb7ad2e284cfabc5ca81a819374a42025-08-20T02:28:10ZengBucharest College of PhysiciansModern Medicine1223-04722360-24732019-12-01264233237https://doi.org/10.31689/rmm.2019.26.4.233Cutaneous Sarcoidosis – Diagnostic ChallengesFlorica SANDRU0Mihai Cristian DUMITRASCU1Adelina POPA2Daniel-Vasile BALABAN3Razvan-Cosmin PETCA4Raluca Gabriela MIULESCU5Department of Dermatology, „Elias” Emergency University Hospital, Bucharest, RomaniaDepartment of Obstetrics and Gynecology, Emergency University Hospital, Bucharest, RomaniaDepartment of Dermatology, „Elias” Emergency University Hospital, Bucharest, RomaniaDepartment of Gastroenterology, „Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest, RomaniaDepartment of Urology, „Prof. Dr. Th. Burghele” Clinical Hospital, Bucharest, RomaniaDepartment of Dermatology, „Elias” Emergency University Hospital, Bucharest, RomaniaSarcoidosis is a multisystemic granulomatous disease, with unknown etiology, characterized histopathologically by the development in the affected organs of some „empty” (non-caseous) granulomas. Cutaneous lesions can sometimes be the first localization of the disease. We present the case of a patient with known sarcoidosis and autoimmune thyroiditis, who developed a rash spread on the trunk and limbs, for which she was treated with dermatocorticoids and antihistamines, but without significant improvement. A skin biopsy was performed with histopathological examination, which revealed: at the dermal level, lympho-histiocytic infiltrates with nodular distribution, forming several granulomas, without areas of necrosis of caseification, including frequent cells with epithelioid appearance, suggestive for the diagnosis of cutaneous sarcoidosis. The patient underwent systemic cortisone therapy and hydroxychloroquine, with favorable outcome. The challenge of diagnosing this pathology is to differentiate it from a number of conditions, including: ring granuloma, cutaneous Crohn’s disease, lipoid necrosis, lupus vulgaris. To establish the diagnosis of certainty, it is necessary to correlate the clinical data with the result of the histopathological examination.https://medicinamoderna.ro/wp-content/uploads/2019/12/RMM_art-11-Cutaneous-Sarcoidosis-%E2%80%93-Diagnostic-Challenges.pdfsarcoidosisgranulomatous diseaselichen planuscutaneous crohn’s diseaselipoid necrobiosisclassic ring granuloma
spellingShingle Florica SANDRU
Mihai Cristian DUMITRASCU
Adelina POPA
Daniel-Vasile BALABAN
Razvan-Cosmin PETCA
Raluca Gabriela MIULESCU
Cutaneous Sarcoidosis – Diagnostic Challenges
Modern Medicine
sarcoidosis
granulomatous disease
lichen planus
cutaneous crohn’s disease
lipoid necrobiosis
classic ring granuloma
title Cutaneous Sarcoidosis – Diagnostic Challenges
title_full Cutaneous Sarcoidosis – Diagnostic Challenges
title_fullStr Cutaneous Sarcoidosis – Diagnostic Challenges
title_full_unstemmed Cutaneous Sarcoidosis – Diagnostic Challenges
title_short Cutaneous Sarcoidosis – Diagnostic Challenges
title_sort cutaneous sarcoidosis diagnostic challenges
topic sarcoidosis
granulomatous disease
lichen planus
cutaneous crohn’s disease
lipoid necrobiosis
classic ring granuloma
url https://medicinamoderna.ro/wp-content/uploads/2019/12/RMM_art-11-Cutaneous-Sarcoidosis-%E2%80%93-Diagnostic-Challenges.pdf
work_keys_str_mv AT floricasandru cutaneoussarcoidosisdiagnosticchallenges
AT mihaicristiandumitrascu cutaneoussarcoidosisdiagnosticchallenges
AT adelinapopa cutaneoussarcoidosisdiagnosticchallenges
AT danielvasilebalaban cutaneoussarcoidosisdiagnosticchallenges
AT razvancosminpetca cutaneoussarcoidosisdiagnosticchallenges
AT ralucagabrielamiulescu cutaneoussarcoidosisdiagnosticchallenges