Subcutaneous Sarcoidosis (Darier Roussy Sarcoid): A Rare Entity of Cutaneous Sarcoidosis

Summary@#Sarcoidosis is a multisystem disease characterised by granulomatous inflammation possibly due to hyperactivation of the immune system; with unknown etiology. Subcutaneous sarcoidosis (also known as Darier Roussy sarcoid) is a rare type of specific cutaneous lesion of sarcoidosis characterised by multiple firm, asymptomatic to mildly tender, mobile, round to oval, and skin coloured nodules. Herein we report a rare case of subcutaneous sarcoidosis.

Clinical and pathological analysis of eight cases of subcutaneous sarcoidosis / 中华皮肤科杂志

Objective@#To investigate clinical and histopathological features of subcutaneous sarcoidosis.@*Methods@#A retrospective analysis was performed. Clinical and pathological data were collected from 8 patients diagnosed with subcutaneous sarcoidosis in Hospital for Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College between 2012 and 2018, and analyzed retrospectively.@*Results@#Out of the 8 patients, 1 was male and 7 were female, with an average onset age of 50.5 years. The main skin manifestations were multiple painless skin-colored subcutaneous nodules, with no history of trauma or ulceration. Other skin lesions included erythema in 1 case and dark-purple plaques in 1 case. Lung involvement was detected in 6 cases, and no other systems were involved. Histopathological findings were mainly non-caseating granulomas in the subcutaneous tissue with negative acid-fast staining. Of the 8 patients, 7 received short-term oral glucocorticoid treatment and achieved remission or subsidence of lesions, 1 patient was lost to follow-up.@*Conclusions@#Subcutaneous sarcoidosis initially manifests as painless skin-colored subcutaneous nodules, which can be complicated by erythema, plaques and so on. Histopathological findings are characterized by non-caseating granulomas. Chronic and mild systemic involvement, especially lung involvement, is common in patients with subcutaneous sarcoidosis, and the prognosis is quite favorable.

Subcutaneous Sarcoidosis in a Patient with Myasthenia Gravis / 대한피부과학회지

Subcutaneous sarcoidosis is rare and presents as tender or painless nodules that mostly occur on the extremities. We report a 47-year-old female patient presenting with a 1-month history of multiple asymptomatic subcutaneous nodules on the extremities. The patient had a history of myasthenia gravis for 5 years. Histopathological findings from the subcutaneous nodules showed non-caseating granulomas compatible with sarcoidosis. On inspection for internal involvement, pulmonary sarcoidosis was also detected by chest computed tomography, bronchoalveolar lavage, and transbronchial lung biopsy. The concurrence of sarcoidosis and myasthenia gravis is rare and has not been reported in the Korean literature. It may be supposed that the concurrence of these 2 separate entities is coincidental, but it has been reported that myasthenia gravis with specific antibodies is associated with sarcoidosis. This suggests that a common immunopathogenic mechanism may exist between these 2 diseases.

Sonographic Appearance of Dermal and Subcutaneous Sarcoidosis: A Case Report

Sarcoidosis is a systemic granulomatous disease of unknown origin that mainly involves lung and skin, but rarely involves subcutaneous tissue. While some studies have reported on CT or MR imaging findings of subcutaneous sarcoidosis, there is only one report on sonographic findings of subcutaneous sarcoidosis, recently published in the US. Familiarity with ultrasonographic findings of subcutaneous sarcoidosis might be helpful for the early diagnosis in patient with palpable nodules and image follow-up for subcutaneous sarcoidosis. Here we report on the sonographic appearance of subcutaneous sarcoidosis involving dermal and subcutaneous tissue over axilla and sole, a case diagnosed as sarcoidosis and improved by steroid treatment, along with a review of the relevant literature.

Subcutaneous Sarcoidosis with Plantar Involvement

Sarcoidosis is a multisystem granulomatous disorder of an unknown etiology. Subcutaneous sarcoidosis is a rare manifestation of sarcoidosis, and plantar involvement is extremely rare and there is only one such case report in the medical literature. Herein we present an interesting case of a patient who was diagnosed as having subcutaneous sarcoidosis at a plantar localization because plantar involvement is extremely rare and also because of the successful outcome after performing intralesional corticosteroid therapy.

A Case of Subcutaneous Sarcoidosis Treated with Hydroxychloroquine / 대한피부과학회지

A 54-year-old woman presented with a one-year history of multiple hard non-tender nodules on the trunk and both upper extremities without other accompanying systemic symptoms. Histopathologic findings of this subcutaneous nodule revealed circumscribed round noncaseating granulomas separated by fibrous tissues. Special stainings such as PAS and AFB showed negative results. She was diagnosed as a subcutaneous sarcoidosis. The patient was treated with systemic corticosteroids and hydroxychloroquine. Skin lesions cleared after 12 weeks of treatment.