Fournier Cynthia, Vallée Sheila, Perron Émilie, Thérien Geneviève
Department of Dermatology, CHU de Québec, Laval University, Québec City, QC, Canada.
Department of Pathology, CHU de Québec, Laval University, Québec City, QC, Canada.
SAGE Open Med Case Rep. 2019 Sep 16;7:2050313X19877274. doi: 10.1177/2050313X19877274. eCollection 2019.
Sarcoidosis is an inflammatory multisystemic disease of unknown etiology with multiple presentations of cutaneous lesions. It characteristically infiltrates scars due to several kind of trauma such as surgery, tattoo and even herpes zoster. We present a case of a 65-year-old woman with progressive distal paresthesia and motor weakness. She was referred to our dermatology clinic for a new violaceous nodular plaque within an old melanoma scar on the posterior neck. On positron emission tomography-computed tomography, there were multiple enlarged thoracic lymphadenopathy and a fluorodeoxyglucose-avid cutaneous lesion on the posterior neck, right in the melanoma scar. Cutaneous and nerve biopsies showed non-necrotising granulomas, supporting the diagnosis of systemic sarcoidosis and excluding melanoma recurrence with metastasis. It is the first case of cutaneous sarcoidosis arising within a melanoma scar. Interestingly, patients with melanoma have a higher risk of sarcoidosis.
结节病是一种病因不明的炎症性多系统疾病，有多种皮肤病变表现。它的特征是会浸润因手术、纹身甚至带状疱疹等多种创伤形成的瘢痕。我们报告一例65岁女性，有进行性远端感觉异常和运动无力。她因后颈部旧黑色素瘤瘢痕内出现新的紫罗兰色结节状斑块被转诊至我们的皮肤科诊所。在正电子发射断层扫描-计算机断层扫描中，发现多个胸部淋巴结肿大，后颈部黑色素瘤瘢痕处有一个氟脱氧葡萄糖摄取阳性的皮肤病变。皮肤和神经活检显示非坏死性肉芽肿，支持系统性结节病的诊断，排除黑色素瘤复发伴转移。这是首例发生于黑色素瘤瘢痕内的皮肤结节病。有趣的是，黑色素瘤患者患结节病的风险更高。
