Fernandez-Faith Esteban, McDonnell Jonelle
Department of Dermatology, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Clin Dermatol. 2007 May-Jun;25(3):276-87. doi: 10.1016/j.clindermatol.2007.03.004.
Sarcoidosis is a multisystem disease with cutaneous lesions present in 20%-35% of patients. Given the wide variability of clinical manifestations, it is one of the "great imitators," making it necessary to consider clinical, epidemiological, radiographic, laboratory, and histopathological criteria to make the diagnosis. Cutaneous lesions have been classified as specific and nonspecific, depending on the presence of noncaseating granulomas on histologic studies. Specific lesions include maculopapules, plaques, nodules, lupus pernio, scar infiltration, alopecia, ulcerative lesions, and hypopigmentation among others. Nail, mucosal, and childhood sarcoidosis represent a distinct subset of the disease process. The most common nonspecific lesion is erythema nodosum. Others include calcifications, prurigo, erythema multiforme, nail clubbing, and Sweet syndrome. The importance of considering cutaneous sarcoidosis in the clinical differential diagnosis of a given skin lesion relies on the association with systemic involvement and the convenience of the skin as a tissue source for histologic analysis.
结节病是一种多系统疾病，20%-35%的患者会出现皮肤病变。鉴于临床表现差异很大，它是“最具迷惑性的疾病之一”，因此有必要综合考虑临床、流行病学、影像学、实验室及组织病理学标准来做出诊断。根据组织学研究中是否存在非干酪样肉芽肿，皮肤病变可分为特异性和非特异性两类。特异性病变包括斑丘疹、斑块、结节、冻疮样狼疮、瘢痕浸润、脱发、溃疡性病变及色素减退等。甲部、黏膜及儿童结节病是疾病进程中的一个独特亚组。最常见的非特异性病变是结节性红斑。其他还包括钙化、痒疹、多形红斑、杵状指及Sweet综合征。在对特定皮肤病变进行临床鉴别诊断时考虑皮肤结节病的重要性，在于其与全身受累的关联以及皮肤作为组织学分析组织来源的便利性。
