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Disfiguring annular sarcoidosis improved by adalimumab.

Kaiser CA, Cozzio A, Hofbauer GF, Kamarashev J, French LE, Navarini AA - Case Rep Dermatol (2011)

Bottom Line: Skin biopsies revealed non-caseating granulomas, and hilar involvement was identified, leading to the diagnosis of systemic sarcoidosis stage II with cutaneous involvement.The lesions proved resistant to multiple therapies, but responded within 4 months to adalimumab with regression of the lesion and inflammatory infiltrate.The visual analogue scale of disease activity decreased from 7/10 to 3.5/10, and the Dermatology Life Quality Index from 16/30 to 3/30 points.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.

ABSTRACT
Depending on the location, dermatoses can produce blemishes that severely impair quality of life and require highly effective treatment that is otherwise used for extensive skin involvement. We report the case of a 39-year-old, otherwise healthy male disfigured by an 8 × 7-cm hypopigmented and centrally atrophic annular plaque with erythematous indurated borders in an area of scar tissue on his forehead. Skin biopsies revealed non-caseating granulomas, and hilar involvement was identified, leading to the diagnosis of systemic sarcoidosis stage II with cutaneous involvement. The lesions proved resistant to multiple therapies, but responded within 4 months to adalimumab with regression of the lesion and inflammatory infiltrate. The visual analogue scale of disease activity decreased from 7/10 to 3.5/10, and the Dermatology Life Quality Index from 16/30 to 3/30 points. In conclusion, TNF-α inhibition can control inflammation and disfigurement by cutaneous sarcoidosis and restore quality of life.

No MeSH data available.


Related in: MedlinePlus

a Hypopigmented and atrophic lesion with indurated erythematous border at diagnosis. b Histopathology before treatment with adalimumab (original magnification 20×). c Lesion after 4 months of treatment with adalimumab.
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Figure 1: a Hypopigmented and atrophic lesion with indurated erythematous border at diagnosis. b Histopathology before treatment with adalimumab (original magnification 20×). c Lesion after 4 months of treatment with adalimumab.

Mentions: A 39-year-old man developed an 8 × 7-cm hypopigmented and centrally atrophic plaque with erythematous indurated borders in an area of scar tissue on his forehead (fig. 1a). On the occipital scalp he presented an erythematous brownish plaque resulting in cicatricial alopecia, as well as multiple brownish patches and papules on the trunk and shins. Skin biopsies from forehead, scalp and the pretibial area showed inflammatory non-caseating granulomas (fig. 1b). Chest X-ray revealed bilateral hilar adenopathy, nodules and reticular opacities, while pulmonary function tests indicated an obstructive ventilation disorder with physiologic diffusion capacity for carbon monoxide. A diagnosis of systemic sarcoidosis stage II with cutaneous and lung involvement was made.


Disfiguring annular sarcoidosis improved by adalimumab.

Kaiser CA, Cozzio A, Hofbauer GF, Kamarashev J, French LE, Navarini AA - Case Rep Dermatol (2011)

a Hypopigmented and atrophic lesion with indurated erythematous border at diagnosis. b Histopathology before treatment with adalimumab (original magnification 20×). c Lesion after 4 months of treatment with adalimumab.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3104865&req=5

Figure 1: a Hypopigmented and atrophic lesion with indurated erythematous border at diagnosis. b Histopathology before treatment with adalimumab (original magnification 20×). c Lesion after 4 months of treatment with adalimumab.
Mentions: A 39-year-old man developed an 8 × 7-cm hypopigmented and centrally atrophic plaque with erythematous indurated borders in an area of scar tissue on his forehead (fig. 1a). On the occipital scalp he presented an erythematous brownish plaque resulting in cicatricial alopecia, as well as multiple brownish patches and papules on the trunk and shins. Skin biopsies from forehead, scalp and the pretibial area showed inflammatory non-caseating granulomas (fig. 1b). Chest X-ray revealed bilateral hilar adenopathy, nodules and reticular opacities, while pulmonary function tests indicated an obstructive ventilation disorder with physiologic diffusion capacity for carbon monoxide. A diagnosis of systemic sarcoidosis stage II with cutaneous and lung involvement was made.

Bottom Line: Skin biopsies revealed non-caseating granulomas, and hilar involvement was identified, leading to the diagnosis of systemic sarcoidosis stage II with cutaneous involvement.The lesions proved resistant to multiple therapies, but responded within 4 months to adalimumab with regression of the lesion and inflammatory infiltrate.The visual analogue scale of disease activity decreased from 7/10 to 3.5/10, and the Dermatology Life Quality Index from 16/30 to 3/30 points.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.

ABSTRACT
Depending on the location, dermatoses can produce blemishes that severely impair quality of life and require highly effective treatment that is otherwise used for extensive skin involvement. We report the case of a 39-year-old, otherwise healthy male disfigured by an 8 × 7-cm hypopigmented and centrally atrophic annular plaque with erythematous indurated borders in an area of scar tissue on his forehead. Skin biopsies revealed non-caseating granulomas, and hilar involvement was identified, leading to the diagnosis of systemic sarcoidosis stage II with cutaneous involvement. The lesions proved resistant to multiple therapies, but responded within 4 months to adalimumab with regression of the lesion and inflammatory infiltrate. The visual analogue scale of disease activity decreased from 7/10 to 3.5/10, and the Dermatology Life Quality Index from 16/30 to 3/30 points. In conclusion, TNF-α inhibition can control inflammation and disfigurement by cutaneous sarcoidosis and restore quality of life.

No MeSH data available.


Related in: MedlinePlus