Sahel Houria, Merrouche Billel, Djennane Nacima, Hebouchi Amine, Maireche Ammar
Service de dermatologie, CHU Bab El Oued, université Alger 1 Benyoucef Benkhada, faculté de médecine, 10, rue Brahim Charafa Bab El Oued, Alger, Algérie; Université d'Alger1, faculté de médecine, Alger, Algérie.
Service de dermatologie, CHU Bab El Oued, université Alger 1 Benyoucef Benkhada, faculté de médecine, 10, rue Brahim Charafa Bab El Oued, Alger, Algérie.
Rev Med Interne. 2025 Mar;46(3):174-178. doi: 10.1016/j.revmed.2025.01.004. Epub 2025 Jan 31.
Sarcoidosis is a multisystem disorder. Skin injury can have a wide range of semiologies. Ulcerated forms have rarely been described.
A 56-year-old woman was operated on for a scalp mass. The pathological study shows tuberculoid granulomas with caseous necrosis of the right temporalis muscle. Two years later, she consulted for ulcerations of the scalp and right leg. Histological examination of the scalp lesion and a back lesion showed gigantocellular granulomas without caseous necrosis. Thoraco-abdomino-pelvic CT scan revealed hilar and abdominopelvic lymphadenopathy. On brain magnetic resonance imaging, signs of myositis of the right temporalis muscle involvement were noted. The diagnosis of ulcerated multisystem sarcoidosis was made. A spectacular improvement was noted after seven months of treatment with systemic prednisone, without recurrence after three years.
We report an original observation of cutaneous ulcerations revealing multisystemic sarcoidosis. Diagnosis of this rare form relies on skin biopsy and exclusion of other cutaneous granulomatoses. The evolution of ulcerative sarcoidosis is usually satisfactory with the usual treatments of sarcoidosis.
结节病是一种多系统疾病。皮肤损伤可有多种表现形式。溃疡性结节病很少被描述。
一名56岁女性因头皮肿物接受手术。病理研究显示右侧颞肌有结核样肉芽肿伴干酪样坏死。两年后，她因头皮和右腿溃疡前来就诊。头皮病变和背部病变的组织学检查显示有巨细胞肉芽肿，无干酪样坏死。胸腹部盆腔CT扫描显示肺门及腹部盆腔淋巴结肿大。脑部磁共振成像显示右侧颞肌受累有肌炎迹象。诊断为溃疡性多系统结节病。经全身泼尼松治疗七个月后有显著改善，三年后无复发。
我们报告了一例以皮肤溃疡为表现的多系统结节病的独特病例。这种罕见形式的诊断依赖于皮肤活检并排除其他皮肤肉芽肿病。溃疡性结节病的病情发展通常通过结节病的常规治疗可取得满意效果。
