Immunophenotyping of a sarcoidal granuloma in a scar, a manifestation of a possible autoimmune process.

BACKGROUND

Old scars rarely develop sarcoid lesions. To determine whether the immunophenotype of the cellular infiltrate found in sarcoid in scarred skin resembled that seen in sardoidosis, we performed routine staining with hematoxylin and eosin, as well as immunophenotyping of a sarcoid lesion in a scar. Currently, there is controversy about the etiology of sarcoidosis in general and about sarcoidal granulomas in scars in particular. A new hypothesis is suggested in this case report.

OBJECTIVE

The purpose was to determine whether the cellular infiltrate in a sarcoidal granuloma in an old scar was similar to that in sarcoidosis.

METHODS

Staining with hematoxylin and eosin as well as immunophenotyping was performed using standard techniques.

RESULTS

The dermis of the sarcoid lesion demonstrated predominantly macrophages, followed by CD-4+ T-helper cells. CD-8+ cytotoxic suppressor cells were rare.

CONCLUSIONS

The lymphoid cell infiltrate in a sarcoidal granuloma found in a scar is similar to that found in sarcoidosis. Furthermore, the staining pattern of sarcoid described in this paper and a review of the data in the literature suggest that sarcoidosis shares many characteristics of diseases with an autoimmune origin. Thus, we suggest that sarcoid isolated to scars represents a more benign variant of sarcoidosis, a possible systemic autoimmune disease.