Yanardağ Halil, Pamuk Omer Nuri, Karayel Tuncer
Department of Lung Diseases, Cerrahpaşa Medical Faculty, University of Istanbul, Istanbul, Turkey.
Respir Med. 2003 Aug;97(8):978-82. doi: 10.1016/s0954-6111(03)00127-6.
In our study, we retrospectively evaluated the clinical features of patients diagnosed as sarcoidosis at our center within the last 36 years and who had skin involvement. Cutaneous involvement was observed in 170 patients (32.9%, 136 females, 34 males). The most frequent skin lesion was erythema nodosum (EN) (106 subjects, 20.5%). In addition, skin plaques and subcutaneous nodules were observed in 22 cases (4.3%), maculopapular eruptions in 19 cases (3.7%), scar lesions in 15 cases (2.9%), lupus pernio (LP) in 14 cases (2.7%) and psoriasiform plaques in five cases (0.9%). Among patients with LP (64.3%) and scar lesions (40%), pulmonary parenchymal involvement was more frequent than patients with other skin lesions. Parenchymal involvement present in 10.4% of patients with EN was significantly less than in patients with LP and scar lesions (P values, respectively, <0.001, 0.002). When patients with skin involvement were compared to other sarcoidosis patients, it was seen that the frequency of females among those with skin involvement was significantly higher than the frequency among other sarcoidosis patients (P<0.001). Parenchymal involvement in sarcoidosis patients without skin involvement was less frequent than in patients with LP; however, more frequent than in patients with EN (both P values=0.002). As a conclusion, skin involvement was diagnosed in approximately one-third of our sarcoidosis patients with a generally female predominance. EN was the most frequent skin lesion encountered. Parenchymal involvement was more frequent in patients with LP and scar lesions and less frequent in patients with EN.
在我们的研究中，我们回顾性评估了过去36年内在我们中心被诊断为结节病且有皮肤受累的患者的临床特征。170例患者出现皮肤受累（32.9%，女性136例，男性34例）。最常见的皮肤损害是结节性红斑（EN）（106例，20.5%）。此外，观察到22例（4.3%）有皮肤斑块和皮下结节，19例（3.7%）有斑丘疹，15例（2.9%）有瘢痕损害，14例（2.7%）有冻疮样狼疮（LP），5例（0.9%）有银屑病样斑块。在LP患者（64.3%）和瘢痕损害患者（40%）中，肺实质受累比其他皮肤损害患者更常见。EN患者中10.4%有实质受累，明显少于LP和瘢痕损害患者（P值分别<0.001、0.002）。将有皮肤受累的患者与其他结节病患者进行比较时，发现有皮肤受累者中女性的比例明显高于其他结节病患者（P<0.001）。无皮肤受累的结节病患者实质受累比LP患者少见；然而，比EN患者更常见（两个P值均=0.002）。总之，我们大约三分之一的结节病患者被诊断有皮肤受累，总体上女性占优势。EN是最常见的皮肤损害。LP和瘢痕损害患者实质受累更常见，EN患者则较少见。
