A Case of Systemic Sarcoidosis Related with Foreign Body Injection for Wrinkle Correction / 대한피부과학회지

ABSTRACT

Sarcoidosis is a generalized granulomatous disease involving many organs such as the lungs, eyes, liver, skin, and lymph nodes. The cutaneous involvement in systemic sarcoidosis appears as various clinical manifestations, being in 9-37% of systemic sarcoidosis. The etiology is uncertain, but many contributing factors such as infection, foreign body reaction, trauma, genetic and environmental influences have been reported. A 54-year-old female presented with a 5-year history of asymptomatic violaceous papules and nodules on the forehead, where she received an injection of unknown material to improve wrinkles 10 years ago. She also complained of general symptoms such as fatigue, weight loss, and intermittent hemoptysis at visit. Chest X-ray revealed multiple ill defined nodular lesions in both lungs. Sarcoidal granulomas consisted of many epithelioid tubercles were found in open lung biopsy. Histopathological study of skin lesion also revealed multiple naked tubercles composed of large epithelioid histiocytes, multinucleated giant cells, few lymphocytes in the dermis. No foreign body was found on the polarized light microscopic examination. Although the exact nature of foreign material is unknown, it is suggested that a foreign body reaction by injected material is related to cutaneous sarcoidosis as well as subsequent systemic development in view of clinical and histological background.