Mahajan Vikram K, Sharma Nand Lal, Sharma Ramesh Chander, Sharma Vikas C
Department of Dermatology, Venereology and Leprosy, Indira Gandhi Medical College, Shimla, India.
Indian J Dermatol Venereol Leprol. 2007 Jan-Feb;73(1):16-21. doi: 10.4103/0378-6323.30645.
Sarcoidosis is a multisystem disease of undetermined etiology. Indian studies on cutaneous sarcoidosis are not many and mainly comprise case reports.
This retrospective study was carried out to assess the clinical profile of sarcoidosis patients presenting with cutaneous lesions.
All histopathologically proven cases of cutaneous sarcoidosis seen consecutively between 1999 and 2004 were studied. Their age, sex, presenting features, evolution of disease and laboratory parameters were analyzed.
A total of 23 patients (F:M 15:8) between 31 to 78 years (mean 44.3 years) of age had the mean duration of skin lesions of 1.4 years. Six patients had one to four lesions; two patients each had scar sarcoidosis and angiolupoid and one patient each had recurrent erythema nodosum, leg lymphedema and subcutaneous sarcoidosis. Others showed combination of papules, nodules, plaques and psoriasiform lesions. Peripheral lymph nodes were involved in two patients. Among 10 patients of pulmonary involvement, three had become symptomatic four months to four years after the cutaneous lesions. Routine laboratory investigations including serum calcium estimation were normal in all cases. Serum angiotensin-converting enzyme levels were raised in 3 out of 6 patients. Asymptomatic lytic lesions of digital bones were detected in hand X-ray of one patient.
Skin lesions of sarcoidosis are like the tip of an iceberg indicating more changes in other organs. The symptomatology and abnormal laboratory results do not necessarily correlate with the severity of cutaneous involvement in general.
结节病是一种病因不明的多系统疾病。印度关于皮肤结节病的研究不多，主要是病例报告。
本回顾性研究旨在评估出现皮肤损害的结节病患者的临床特征。
对1999年至2004年间连续就诊的所有经组织病理学证实的皮肤结节病病例进行研究。分析了他们的年龄、性别、临床表现、疾病演变及实验室参数。
共有23例患者（女性：男性为15：8），年龄在31至78岁之间（平均44.3岁），皮肤损害的平均病程为1.4年。6例患者有1至4处损害；2例患者分别患有瘢痕结节病和血管狼疮样病变，1例患者分别患有复发性结节性红斑、腿部淋巴水肿和皮下结节病。其他患者表现为丘疹、结节、斑块和银屑病样损害的组合。2例患者出现外周淋巴结受累。在10例有肺部受累的患者中，3例在皮肤损害出现4个月至4年后出现症状。所有病例的常规实验室检查包括血清钙测定均正常。6例患者中有3例血清血管紧张素转换酶水平升高。1例患者手部X线检查发现指骨无症状性溶骨性损害。
结节病的皮肤损害就像冰山一角，提示其他器官可能有更多变化。一般来说，症状和异常实验室结果不一定与皮肤受累的严重程度相关。
