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Publisher: Peytchinski Publishing
ISSN: 1312-773X (Online)
Issue: 2017, vol. 23, issue 2
Subject Area: Medicine - Toxicology
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DOI: 10.5272/jimab.2017232.1560
Published online: 23 May 2017
Case Report
J of IMAB 2017 Apr-Jun;23(2):1560-1563
A CASE REPORT OF SARCOIDOSIS CUTIS LICHENOIDES
Desislava Tsvetanova1
, Ivelina A.Yordanova1, Verka Pavlova1, Tatyana Betova2, Dimitar K. Gospodinov1,
1) Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University - Pleven, Bulgaria
2) Department of General and Clinical Pathology, Faculty of Medicine, Medical University Pleven, Bulgaria.
ABSTRACT:
Background: Sarcoidosis is a chronic multisystem granulomatous disease of unknown etiology, characterised bytheformation of noncaseating granulomas in the involved organs, such as the skin, lung, lymph nodes, eyes, joints, brain, kidneys and heart. Cutaneous involvement is about 25% with different clinical presentations, including papules, nodules, plaques, and infiltrated scars. The lichenoid pattern is one of the rarest types of cutaneous sarcoidosis.
Purpose: To present 50 –year-old woman diagnosed with Sarcoidosis cutis lichenoides.
Material and methods: We present a 50-year-old woman in good general condition, with skin rashes localised on upper limbs. The disease started four months ago. From physical examination, pathological cutaneous lesions affected right and left forearms and cubital folds, presented by papules of various sizes, pink in colour, smooth and shiny. Complete blood count, biochemistry, urine analysis and microbiology were in normal ranges except elevated levels of alpha-1 globulin and gamma- globulin. X-rays examination and abdominal ultrasound were normal too. Mantoux test was negative. Histopathological examination demonstrated granulomas located in the papillary dermis and composedof epithelioid and giant cells, a few lymphocytes, without necrosis. Consultations with pulmonologist and ophthalmologist showed no abnormalities.
Results: The diagnosis Sarcoidosis cutis lichenoides was based on the medical history, general status, and morphological characteristics of skin lesions, histopathological examination and consultations. In the absence of organ involvement, systemic therapy with Methylprednisolone and topical treatment with Flumetasone pivalate 0.2mg/Salicylic acid 30mg/g was started. On the 5th day of treatment, we revealed initial resorption of papules. After discharging the patient from the hospital, systemic therapy with Methylprednisolone and topical treatment with Tacrolimus 0.1% ointment was conducted. There were no new lesions 3 months after the end of the therapy with Tacrolimus 0.1% ointment.
Keywords: Sarcoidosis cutis lichenoides, lichenoid pattern, tacrolimus,
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Please cite this article in PubMed Style or AMA (American Medical Association) Style:
Tsvetanova D, Yordanova IA,Pavlova V, Betova T, Gospodinov DK. A case report of Sarcoidosis cutis lichenoides. J of IMAB. 2017 Jan-Mar;23(2):1560-1563. DOI: 10.5272/jimab.2017232.1560
Correspondence to: Desislava Tsvetanova, Department of Dermatologу, Venereology and Allergology, Faculty of Medicine, Medical University – Pleven; 91, Gen. Vladimir Vazov str., Pleven, Bulgaria; E-mail: desi_tzvetanova@abv.bg
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Received: 20 January 2017
Published online: 23 May 2017