Berg Sara A, Novoa Roberto A, Stewart Campbell, Sobanko Joseph F, Miller Christopher J, Rosenbach Misha
Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
Department of Dermatology, University of Pennsylvania, Philadelphia, USA.
Cutis. 2016 Dec;98(6):377-380.
Sarcoidosis is a chronic multisystem disease characterized by the formation of noncaseating granulomas in multiple organs, including the skin. An association between multisystem sarcoidosis and an increased risk for malignancy has been established. Dermatologists should be aware of the increased risk for nonmelanoma skin cancers in patients with sarcoidosis. We report a series of 3 patients with primarily cutaneous sarcoidosis who presented with new-onset cutaneous squamous cell carcinoma (SCC). Two patients were black women and 1 patient presented with lesions of cutaneous sarcoidosis arising concurrently with SCCs in the same location, distinguishable only by biopsy. These cases highlight the association between sarcoidosis and an increased risk for SCC. Because dermatologists may be the primary clinicians caring for these patients, it is important that they remain aware of the increased risk for cutaneous malignancies and that they have a low threshold for biopsy of new and unusual skin lesions. Furthermore, 2 patients were black women, a population not commonly affected by skin cancer, which further exemplifies the need for comprehensive skin examinations in black patients. Although the precise mechanism for an increased risk for malignancy in these patients requires further investigation, chronic inflammation and immune dysregulation may play a role.
结节病是一种慢性多系统疾病，其特征是在包括皮肤在内的多个器官中形成非干酪样肉芽肿。多系统结节病与恶性肿瘤风险增加之间的关联已得到证实。皮肤科医生应意识到结节病患者发生非黑素瘤皮肤癌的风险增加。我们报告了一系列3例主要为皮肤结节病的患者，他们出现了新发皮肤鳞状细胞癌（SCC）。2例为黑人女性，1例患者皮肤结节病病变与同一部位的SCC同时出现，仅通过活检才能区分。这些病例突出了结节病与SCC风险增加之间的关联。由于皮肤科医生可能是照料这些患者的主要临床医生，因此他们必须意识到皮肤恶性肿瘤风险增加，并且对新出现的和不寻常的皮肤病变进行活检的阈值要低，这一点很重要。此外，2例为黑人女性，这是一个通常不受皮肤癌影响的人群，这进一步说明了对黑人患者进行全面皮肤检查的必要性。尽管这些患者恶性肿瘤风险增加的确切机制需要进一步研究，但慢性炎症和免疫失调可能起了作用。
