Department of Dermatology, Fukushima Medical University, Fukushima, Japan.
An Bras Dermatol. 2022 Jul-Aug;97(4):505-507. doi: 10.1016/j.abd.2021.05.018. Epub 2022 May 25.
A 41-year-old female visited our department complaining of asymptomatic subcutaneous nodules on the right forearm. She had been diagnosed as having Cushing syndrome due to an adrenal tumor 5-months previously. After she underwent surgery for the adrenal tumor, the subcutaneous nodules gradually increased in number. Physical examination showed ill-defined plate-like subcutaneous indurations on the bilateral lower extremities, buttocks, and right forearm. A biopsy of one of the subcutaneous indurations showed non-caseating epithelioid cell granulomas involving the hypodermis and subcutaneous tissues. The patient was diagnosed as having sarcoidosis based on the Japan Society of Sarcoidosis and Other Granulomatous Disorders 2015 criteria. Skin lesions decreased in size and had completely disappeared. Although the mechanism is unknown, there may be a possibility that the activity of sarcoidosis is suppressed by high cortisol concentrations due to Cushing syndrome.
一位 41 岁女性因右前臂无症状皮下结节就诊于我科。她 5 个月前因肾上腺肿瘤被诊断为库欣综合征。肾上腺肿瘤手术后，皮下结节逐渐增多。体格检查显示双侧下肢、臀部和右前臂有界限不清的板状皮下硬结。一处皮下硬结的活检显示真皮和皮下组织中有非干酪样上皮样细胞肉芽肿。根据日本结节病和其他肉芽肿性疾病学会 2015 年标准，该患者被诊断为结节病。皮肤病变的大小减小，已完全消失。尽管机制尚不清楚，但库欣综合征导致的高皮质醇浓度可能抑制了结节病的活动。
