Akyol Lütfi, Aslan Kerim, Özgen Metin, Sayarlioglu Mehmet
Department of Internal Medicine, Division of Rheumatology, Ondokuz Mayıs University Hospital, Samsun, Turkey.
Department of Radiology, Ondokuz Mayıs University Hospital, Samsun, Turkey.
BMJ Case Rep. 2015 Nov 17;2015:bcr2015211439. doi: 10.1136/bcr-2015-211439.
We present a case of a neurosarcoidosis patient with skin lesions. A 50-year-old woman was admitted with a 1-year history of violaceous, smooth and shiny plaques on her face and right arm. These lesions were biopsied and the histological examination indicated sarcoidosis. The patient had a history of headache and syncope that lasted for about 1 h. Brain CT showed masses measuring 37×20 mm in both frontal lobes. Thoracic and abdominal CT showed many pathologically enlarged lymph nodes. The patient was diagnosed with cutaneous, lung and neuronal sarcoidosis, and treated with 20 mg/day methylprednisolone, 15 mg/week methotrexate, 10 mg/week folic acid, 400 mg/day hydroxychloroquine and 800 mg/day carbamazepine. One month later, the patient's neurological symptoms had improved and her skin lesions had decreased. At 6-month follow-up, the size of the cranial masses had markedly regressed.
我们报告一例患有皮肤病变的神经结节病患者。一名50岁女性因面部和右臂出现紫红色、光滑且有光泽的斑块1年而入院。对这些病变进行了活检,组织学检查显示为结节病。该患者有持续约1小时的头痛和晕厥病史。脑部CT显示双侧额叶有大小为37×20 mm的肿块。胸部和腹部CT显示许多病理性肿大的淋巴结。该患者被诊断为皮肤、肺部和神经结节病,并接受了每日20 mg甲泼尼龙、每周15 mg甲氨蝶呤、每周10 mg叶酸、每日400 mg羟氯喹和每日800 mg卡马西平的治疗。1个月后,患者的神经症状有所改善,皮肤病变减少。在6个月的随访中,颅内肿块大小明显缩小。