Pfau A, Abd-el-Raheem T, Landthaler M
Dermatologische Klinik und Poliklinik, Universität, Regensburg.
Hautarzt. 1995 Apr;46(4):250-4. doi: 10.1007/s001050050249.
Scar sarcoidosis is one of the rare cutaneous manifestations of sarcoidosis. Apart from the clinical picture, suppression of the cell-mediated immunity can often be determined when tuberculin tests and testing for recall antigens are carried out. In the present case of a 68-year-old woman patient scar sarcoidosis and pulmonary sarcoidosis were detected. Remarkably, a strongly positive tuberculin reaction was found, while acute tuberculosis and former BCG vaccination were excluded. Both references in the literature and the case presented demonstrate that a positive tuberculin test, while very unusual in sarcoidosis, does not however, preclude the diagnosis. On the basis of some case reports in the literature, our patient was treated with allopurinol; impressive improvement of both the skin and the pulmonary manifestations was noted. Despite the well-known phenomenon of spontaneous regression in sarcoidosis, we recommend a clinical trial with allopurinol as this substance is well tolerated.
瘢痕结节病是结节病罕见的皮肤表现之一。除临床表现外，进行结核菌素试验和回忆抗原检测时，常可发现细胞介导免疫受到抑制。在本例68岁女性患者中，检测到瘢痕结节病和肺部结节病。值得注意的是，结核菌素反应呈强阳性，同时排除了急性结核病和既往卡介苗接种史。文献参考资料及所呈现的病例均表明，结核菌素试验阳性在结节病中虽非常少见，但并不排除诊断。根据文献中的一些病例报告，我们对该患者使用别嘌醇进行治疗；皮肤和肺部表现均有显著改善。尽管结节病存在众所周知的自发缓解现象，但鉴于该药物耐受性良好，我们建议对别嘌醇进行临床试验。
