ABSTRACT
Scar sarcoidosis is a rare variant of cutaneous sarcoidosis that develops from an inactive scar. Scars due to various traumas including surgery, vaccines, cosmetic tattoos, and herpes zoster have been reported to be associated with sarcoidosis. Subcutaneous nodules are the most common clinical feature in Korean cutaneous sarcoidosis followed by papules and erythema. Non-caseating granulomas with a sparse lymphocytic infiltrate that are referred to as "naked granulomas" are the characteristic histopathological feature of cutaneous sarcoidosis. Two female patients aged 45 and 61 years presented with subcutaneous nodules on both blepharoplasty scars. A 46-year-old female also presented with subcutaneous nodules on scars on the palm and perineum obtained subsequent to trauma and episiotomy, respectively. Chest radiography showed bilateral hilar lymphadenopathy in the third patient. A diagnosis of sarcoidosis was made in all 3 patients based on clinical and histopathological findings with the exclusion of other granulomatous diseases. Herein, we report 3 cases of scar sarcoidosis arising from various types of traumatized skin.
Subject(s)
Female , Humans , Middle Aged , Blepharoplasty , Cicatrix , Diagnosis , Episiotomy , Erythema , Granuloma , Herpes Zoster , Lymphatic Diseases , Perineum , Radiography , Sarcoidosis , Skin , Thorax , VaccinesABSTRACT
PURPOSE: We report the case of a patient with scar sarcoidosis that developed along a previous eyelid scar. There was no evidence of ocular or systemic sarcoidosis. METHODS: A 29-year-old man presented with a mass on his right eyelid that had been present for two month. On ocular examination an erythematous, firm, and non-tender mass was diffusely palpable along the upper and lower eyelid scar. We performed an incisional biopsy of the lower lid mass. RESULTS: Histopathologic examination of the mass revealed numerous, noncaseating granulomas with multi-nucleated giant cells. The giant cells contained asteroid bodies and calcium oxalate crystals characteristic of sarcoidosis, although the patient had no other evidence of systemic sarcoidosis. The mass in the upper lid disappeared after intralesional triamcinolone injections. CONCLUSIONS: This case represents a rare occurrence of sarcoidosis that arose in an old eyelid scar. Scar sarcoidosis should be considered in the differential diagnosis of an unusual mass in a scar.
Subject(s)
Male , Humans , Adult , Triamcinolone/administration & dosage , Sarcoidosis/drug therapy , Injections, Intralesional , Glucocorticoids/administration & dosage , Follow-Up Studies , Eyelids/injuries , Eyelid Diseases/drug therapy , Eye Injuries/complications , Diagnosis, Differential , Cicatrix/complications , BiopsyABSTRACT
Scar sarcoidosis is a rarely encountering variant of cutaneous sarcoidosis and its pathogenesis is still unknown. When inactive scars that have been quiescent for years develop a red or purple hue with induration, we should doubt whether they become infiltrated with sarcoid granuloma or not. We report herein a 45-year-old patient with recurrent scar sarcoid, who shows indurated plaques on the right chin and raised serum level of angiotensin converting enzyme, although there was no evidence of systemic involvement. She was treated with oral doxycycline of moderate doses and skin lesions were cleared after 9 months of treatment.