Mizuno Kana, Nguyen Chuyen Thi Hong, Ueda-Hayakawa Ikuko, Okamoto Hiroyuki
Department of Dermatology, Kansai Medical University, Osaka, Japan.
J Cutan Pathol. 2017 May;44(5):494-496. doi: 10.1111/cup.12912. Epub 2017 Mar 2.
Sarcoidosis is known to be involved in diseases with vasculitis as sarcoid vasculitis. However, vasculitis in cutaneous sarcoidal lesions is extremely rare. Here we describe a case of sarcoidosis with multiple annular skin lesions with granulomatous vasculitis. A 62-year-old female was diagnosed with sarcoidosis by chest-abdominal computed tomographic examination and laboratory tests. The skin lesions had appeared on her lower limbs 2 years before. Physical examination showed multiple infiltrated annular eruptions on the lower extremities. A skin biopsy of an area of erythema showed multiple non-caseating epithelioid cell granulomas in the dermis and subcutaneous fat and granulomatous vasculitis with fibrinoid degeneration in the subcutaneous fat. There are two types of vasculitis in sarcoidosis: leukocytoclastic and granulomatous vasculitis. Ulcers and livedo were more common in granulomatous vasculitis than in leukocytoclastic vasculitis. The present case had unique annular skin lesions of sarcoidosis with granulomatous vasculitis.
结节病被认为与结节性血管炎等血管炎疾病有关。然而，皮肤结节性病变中的血管炎极为罕见。在此，我们描述一例患有多个环形皮肤病变且伴有肉芽肿性血管炎的结节病病例。一名62岁女性通过胸腹部计算机断层扫描检查和实验室检查被诊断为结节病。皮肤病变在2年前出现在她的下肢。体格检查显示下肢有多个浸润性环形皮疹。对一处红斑区域进行皮肤活检，结果显示真皮和皮下脂肪中有多个非干酪样上皮样细胞肉芽肿，皮下脂肪中有伴有纤维蛋白样变性的肉芽肿性血管炎。结节病中有两种类型的血管炎：白细胞破碎性血管炎和肉芽肿性血管炎。溃疡和青斑在肉芽肿性血管炎中比在白细胞破碎性血管炎中更常见。本病例具有伴有肉芽肿性血管炎的独特的结节病环形皮肤病变。
