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Sarcoidosis with photosensitive lesions: a rare variant.

Gangopadhyay A, Das JK, Sengupta S - Indian J Dermatol (2009)

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The final diagnosis was cutaneous sarcoidosis with photosensitive lesions... Typical sarcoid granuloma was seen in histopathology [Figure 8, Figure 9]... Other relevant tests done were also normal... Sunscreens, topical steroids and hydroxychloroquine sulphate (200mg EOD) produced significant improvement within three months [Figure 10]... Sarcoid lesions mimicking lupus have been reported before... Case 2 closely resembled granuloma annulare, but photosensitivity, negative Mantoux test, classical naked granuloma without any necrobiosis and raised SACE helped to exclude it... In a recently published study of 23 Indian sarcoid patients, photosensitive skin lesions have not been documented... The preferential distribution of skin lesions in photo-exposed areas and the significant clearing with hydroxychloroquine sulphate are the two aspects that make the cases special... A French article describes a Tunisian woman with papular erythema of the face, unresponsive to topical steroids... She was histologically diagnosed to be a case of cutaneous sarcoid and the authors opined that photo-induced sarcoid is a distinct entity... Our cases further strengthen the view.

No MeSH data available.


Clearing of lesions after nine months
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Figure 0006: Clearing of lesions after nine months

Mentions: A 63-year-old nurse presented with mildly pruritic papules and coalescent plaques on the forehead, extensor aspect of arms, and upper back [Figure 1, Figure 2]. On exposure to the sun, she experienced mild redness and a burning sensation in all her skin lesions. There was no fever, dyspnea, joint pain or oral ulcers. Systemic examination was normal. Tests revealed mild anemia (11 mg%), raised ESR (50 mm), negative Mantoux reaction and antinuclear antibody. Biopsy of a papule from the back showed epithelioid granuloma with sparse lymphocytes, occasional giant cells and no caseation [Figure 3, Figure 4]. Subsequent investigations revealed raised serum angiotensin converting enzyme (SACE, 128 U/L), serum calcium 9.8mg/dl, and normal chest radiograph, pulmonary and liver functions. Ophthalmoscopic evaluation was normal. The final diagnosis was cutaneous sarcoidosis with photosensitive lesions. She was given oral prednisolone (30mg/day, tapered off by two weeks) and hydroxychloroquine sulphate (HCQS, 200mg/day) along with sunscreens. This produced excellent results by four months with almost complete clearing of the skin lesions within nine months [Figure 5, Figure 6].


Sarcoidosis with photosensitive lesions: a rare variant.

Gangopadhyay A, Das JK, Sengupta S - Indian J Dermatol (2009)

Clearing of lesions after nine months
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2800887&req=5

Figure 0006: Clearing of lesions after nine months
Mentions: A 63-year-old nurse presented with mildly pruritic papules and coalescent plaques on the forehead, extensor aspect of arms, and upper back [Figure 1, Figure 2]. On exposure to the sun, she experienced mild redness and a burning sensation in all her skin lesions. There was no fever, dyspnea, joint pain or oral ulcers. Systemic examination was normal. Tests revealed mild anemia (11 mg%), raised ESR (50 mm), negative Mantoux reaction and antinuclear antibody. Biopsy of a papule from the back showed epithelioid granuloma with sparse lymphocytes, occasional giant cells and no caseation [Figure 3, Figure 4]. Subsequent investigations revealed raised serum angiotensin converting enzyme (SACE, 128 U/L), serum calcium 9.8mg/dl, and normal chest radiograph, pulmonary and liver functions. Ophthalmoscopic evaluation was normal. The final diagnosis was cutaneous sarcoidosis with photosensitive lesions. She was given oral prednisolone (30mg/day, tapered off by two weeks) and hydroxychloroquine sulphate (HCQS, 200mg/day) along with sunscreens. This produced excellent results by four months with almost complete clearing of the skin lesions within nine months [Figure 5, Figure 6].

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

The final diagnosis was cutaneous sarcoidosis with photosensitive lesions... Typical sarcoid granuloma was seen in histopathology [Figure 8, Figure 9]... Other relevant tests done were also normal... Sunscreens, topical steroids and hydroxychloroquine sulphate (200mg EOD) produced significant improvement within three months [Figure 10]... Sarcoid lesions mimicking lupus have been reported before... Case 2 closely resembled granuloma annulare, but photosensitivity, negative Mantoux test, classical naked granuloma without any necrobiosis and raised SACE helped to exclude it... In a recently published study of 23 Indian sarcoid patients, photosensitive skin lesions have not been documented... The preferential distribution of skin lesions in photo-exposed areas and the significant clearing with hydroxychloroquine sulphate are the two aspects that make the cases special... A French article describes a Tunisian woman with papular erythema of the face, unresponsive to topical steroids... She was histologically diagnosed to be a case of cutaneous sarcoid and the authors opined that photo-induced sarcoid is a distinct entity... Our cases further strengthen the view.

No MeSH data available.