Mahabal Gauri D, Peter Dincy C V, George Leni, Thomas Meera, Pulimood Susanne A
Department of Dermatology, Christian Medical College, Vellore, Tamil Nadu, India.
Department of Pathology, Christian Medical College, Vellore, Tamil Nadu, India.
Indian Dermatol Online J. 2021 Jul 14;12(4):566-571. doi: 10.4103/idoj.IDOJ_606_20. eCollection 2021 Jul-Aug.
Sarcoidosis is a systemic disorder characterized histologically by noncaseating granulomas. There is paucity of Indian data on cutaneous sarcoidosis.
To describe the clinical, histopathological findings, and extracutaneous involvement in cutaneous sarcoidosis.
A retrospective study was done in patients of cutaneous sarcoidosis who had attended the dermatology clinic of a tertiary health care center in India from May 2009 to April 2015. The clinical details, histopathological findings, treatment, and response were reviewed.
There were 38 patients with cutaneous sarcoidosis. Mean age was 48 ± 13 years; 58% were female. Median duration of disease was 11 months (IQR 4-48 months). More than one morphology was seen in 28.9%, commonest being plaques (65.7%), and papules (50%). Erythema nodosum was rare. More than one site was involved in 55.3%, most commonly trunk (52.6%). Six patients had isolated cutaneous sarcoidosis. Commonest extracutaneous organs involved were lung (73.7%) and lymph nodes (68.4%). Histopathologically, classical naked sarcoidal granulomas were found in only 55.3%. Angiotensin converting enzyme (ACE) levels were elevated in 74.3% (26/35) with significant association with extracutaneous disease. Treatment included topical and/or systemic corticosteroids, hydroxychloroquine, and tacrolimus.
Pearson's Chi-square test was done to analyze associations between the skin lesions, ACE levels, and systemic involvement; < 0.05 was considered significant.
Cutaneous manifestations of sarcoidosis are varied, commonest being erythematous plaques. Even though most patients had systemic involvement, we found no significant association of the type and number of skin lesions with extracutaneous involvement or prognosis. Elevated ACE levels were significantly associated with systemic involvement.
结节病是一种以非干酪样肉芽肿为组织学特征的全身性疾病。关于皮肤结节病，印度的数据较少。
描述皮肤结节病的临床、组织病理学表现及皮肤外受累情况。
对2009年5月至2015年4月期间在印度一家三级医疗保健中心皮肤科门诊就诊的皮肤结节病患者进行回顾性研究。回顾了临床细节、组织病理学表现、治疗及反应情况。
共有38例皮肤结节病患者。平均年龄为48±13岁；58%为女性。疾病中位病程为11个月（四分位间距4 - 48个月）。28.9%的患者可见不止一种形态，最常见的是斑块（65.7%）和丘疹（50%）。结节性红斑罕见。55.3%的患者累及不止一个部位，最常见的是躯干（52.6%）。6例患者为孤立性皮肤结节病。最常受累的皮肤外器官是肺（73.7%）和淋巴结（68.4%）。组织病理学上，仅55.3%发现典型的裸结节病肉芽肿。74.3%（26/35）的患者血管紧张素转换酶（ACE）水平升高，与皮肤外疾病有显著相关性。治疗包括局部和/或全身用皮质类固醇、羟氯喹和他克莫司。
采用Pearson卡方检验分析皮肤病变、ACE水平与全身受累之间的关联；P<0.05被认为具有统计学意义。
结节病的皮肤表现多样，最常见的是红斑性斑块。尽管大多数患者有全身受累，但我们发现皮肤病变的类型和数量与皮肤外受累或预后之间无显著关联。ACE水平升高与全身受累显著相关。
