Background: Subcutaneous sarcoidosis is a specific cutaneous lesion of sarcoidosis that is rarely reported. Objective: Our purpose was to analyse the clinicop athological features of 10 patients with subcutaneous sarc...Background: Subcutaneous sarcoidosis is a specific cutaneous lesion of sarcoidosis that is rarely reported. Objective: Our purpose was to analyse the clinicop athological features of 10 patients with subcutaneous sarcoidosis and its relati onship with the systemic features of the disease. Patients and methods: The pati ents with systemic sarcoidosis, diagnosed from 1974 to 2002 at a university hosp ital in Barcelona, Spain, who developed subcutaneous involvement, were included in the study. The diagnosis of systemic sarcoidosis was made according to conven tional criteria. All the patients were monitored prospectively at the sarcoidosi s clinic of the hospital. Skin biopsies were performed when granulomatous cutane ous involvement was suspected clinically. Results: Granulomatous cutaneous involvement was demonst rated in 85 of 480 patients with systemic sarcoidosis. In 10 of these 85 patient s subcutaneous sarcoidosis was diagnosed (11.8%). The lesions were most frequen tly located in the extremities, involving the forearms in nine patients. Indurat ed linear bands from the elbow to the hand were observed in five patients. In al l of our patients the subcutaneous nodules appeared at the beginning of the dise ase. In six patients, the nodules remitted spontaneously in less than 2 years. I n two cases foreign particles were detected under polarized light. Conclusions: Subcutaneous sarcoidosis is a quite uniform clinicopathological entity usually a ppearing at the beginning of the disease. It usually heralds forms of sarcoidosi s with nonsevere systemic involvement and is not associated with chronic fibroti cdisease.展开更多
Background: Skin is involved in 25% of cases of sarcoidosis. The lesions are specific and nonspecific depending on the presence or absence of granulomas, respectively. Specific lesions are not thought to have prognost...Background: Skin is involved in 25% of cases of sarcoidosis. The lesions are specific and nonspecific depending on the presence or absence of granulomas, respectively. Specific lesions are not thought to have prognostic significance and are not associated with systemic disease. Objective: We sought to evaluate for the presence or absence of systemic disease in patients with subcutaneous sarcoidosis. Methods: With diagnostic criteria of subcutaneous sarcoidosis, 33 cases were identified in the literature and 21 cases in our institutional database. A retrospective clinical and pathologic review of these cases was conducted. Results: Subcutaneous sarcoidosis is characterized by a peak incidence during the fourth decade; female predisposition; asymptomatic to slightly tender lesions typically involving the upper extremities; cutaneous lesional clustering and multiplicity; autoimmune disease associations at time of diagnosis in a subset of cases; systemic disease associations at diagnosis in most patients, typically consisting of bilateral hilar adenopathy; and a favorable response to oral corticosteroid therapy. Limitations: Retrospective analysis with inadequate documentation of therapeutic regimens and their responses in some cases is a limitation of this study. Conclusions: The confirmatory diagnosis of subcutaneous sarcoidosis depends on identifying pannicular noninfectious sarcoidal or epithelioid granulomas with minimal lymphocytic inflammation. Subcutaneous sarcoidosis is the only specific subset of cutaneous sarcoidosis frequently associated with systemic disease.展开更多
文摘Background: Subcutaneous sarcoidosis is a specific cutaneous lesion of sarcoidosis that is rarely reported. Objective: Our purpose was to analyse the clinicop athological features of 10 patients with subcutaneous sarcoidosis and its relati onship with the systemic features of the disease. Patients and methods: The pati ents with systemic sarcoidosis, diagnosed from 1974 to 2002 at a university hosp ital in Barcelona, Spain, who developed subcutaneous involvement, were included in the study. The diagnosis of systemic sarcoidosis was made according to conven tional criteria. All the patients were monitored prospectively at the sarcoidosi s clinic of the hospital. Skin biopsies were performed when granulomatous cutane ous involvement was suspected clinically. Results: Granulomatous cutaneous involvement was demonst rated in 85 of 480 patients with systemic sarcoidosis. In 10 of these 85 patient s subcutaneous sarcoidosis was diagnosed (11.8%). The lesions were most frequen tly located in the extremities, involving the forearms in nine patients. Indurat ed linear bands from the elbow to the hand were observed in five patients. In al l of our patients the subcutaneous nodules appeared at the beginning of the dise ase. In six patients, the nodules remitted spontaneously in less than 2 years. I n two cases foreign particles were detected under polarized light. Conclusions: Subcutaneous sarcoidosis is a quite uniform clinicopathological entity usually a ppearing at the beginning of the disease. It usually heralds forms of sarcoidosi s with nonsevere systemic involvement and is not associated with chronic fibroti cdisease.
文摘Background: Skin is involved in 25% of cases of sarcoidosis. The lesions are specific and nonspecific depending on the presence or absence of granulomas, respectively. Specific lesions are not thought to have prognostic significance and are not associated with systemic disease. Objective: We sought to evaluate for the presence or absence of systemic disease in patients with subcutaneous sarcoidosis. Methods: With diagnostic criteria of subcutaneous sarcoidosis, 33 cases were identified in the literature and 21 cases in our institutional database. A retrospective clinical and pathologic review of these cases was conducted. Results: Subcutaneous sarcoidosis is characterized by a peak incidence during the fourth decade; female predisposition; asymptomatic to slightly tender lesions typically involving the upper extremities; cutaneous lesional clustering and multiplicity; autoimmune disease associations at time of diagnosis in a subset of cases; systemic disease associations at diagnosis in most patients, typically consisting of bilateral hilar adenopathy; and a favorable response to oral corticosteroid therapy. Limitations: Retrospective analysis with inadequate documentation of therapeutic regimens and their responses in some cases is a limitation of this study. Conclusions: The confirmatory diagnosis of subcutaneous sarcoidosis depends on identifying pannicular noninfectious sarcoidal or epithelioid granulomas with minimal lymphocytic inflammation. Subcutaneous sarcoidosis is the only specific subset of cutaneous sarcoidosis frequently associated with systemic disease.
