Journals / Solunum Hastalıkları / 2007 / Cilt: 18 - Sayı: 1
Cutaneous involvement in sarcoidosis: Analysis of 42 cases
- Journal
- Solunum Hastalıkları
- Pages
- 1–6
- DOI
- —
Abstract
Aim: Our aim is to evaluate skin involvement in sarcoidosis followed in our clinic. Material and Methods: In this study, we retrospectively analyzed skin involvement in 148 sarcoidosis patients. Results: Avarage of patients with cutaneous involvement was 44.1 years (26-76); 36 were female and 6 were males. Sixty-five cutaneous involvements were observed in 42 (28.4%) patients. There were also more than one cutaneous lesion in 10 patients. According 65 cutaneous involvement; erythema nodosum accepted as one of the nonspecific sign was seen in 33 (50.8%) of the cases and specific lesions which were subcutaneous nodules in 15 (23%), maculopapuler lesions in 7 (10.8%), plaques in 5 (7.7%), verrucous form in 2 (3.1%), lupus pernio in 2 (3.1%), scar sarcoid in 1 (1.5%) of the cases were observed. In three patients cutaneous lesions had been developed in follow-up years. The diagnosis was made by skin biopsy in 11 patients (52.4%) who had specific lesions. In the other patients the diagnostic procedures were bronchoscopy, mediastinoscopy or peripheral lymph node biopsy. In the other ten patients who refused invasive diagnostic tools diagnosis were made by clinical- radiological (three of ten were supported by Gallium scintigraphy). Among the patients with skin involvement four cases were in stage 0, 17 cases were in stage I, 19 cases were in stage 2, and two cases were in stage 3.17/42 cases had been treated because of different indications other than skin lesions. Two of the three patients who had only skin lesions had lupus pernio and one had skin lesions caused disfiguring on the face were treated with steroid and/or chloroqine. Conclusion: We concluded that; in the diagnosis of sarcoidosis if skin lesions are detected with thorough physical examination, the diagnosis can be made easier, lesser invasive and lesser expensive than the other invasive diagnostic procedures, when evaluated with the other clinical signs, by the way of biopsy from this lesions.
Özet
Amaç: Kliniğimizde takip edilen sarkoidozlu olgularda cilt tutulumunun değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Bu çalışmada 148 sarkoidli hastada cilt tutulumu retrospektif olarak araştırıldı. Sonuçlar: Cilt tutulumu olan olguların 36'sı kadın, 6'sı erkek, yaş ortalamaları 44.1 (26-76) yıl idi. Kırk iki (%28.4) olguda 65 cilt bulgusu saptandı. On olguda birden çok cilt bulgusu vardı. Altmış beş lezyon içindeki sayısal dağılıma bakıldığında; nonspesifik bulgu olan eritema nodozum 33 (%50.8), spesifik lezyonlardan cilt altı nodülü 15 (%23), makü-lopapüler lezyonlar 7 (%10.8), plaklar 5 (%7.7), verrüköz form 2 (%3.1) lupus pernio 2 (%3.1), skar sarkoidi 1 (%1.5) olarak tespit edildi. Üç olguda spesifik cilt bulguları hastaların takip yıllarında ortaya çıkmıştı. Spesifik lezyonları olan 11 (%52.4) olguda sarkoidoz tanısı cilt biyopsisi ile konulmuştu. Diğerlerine ise tanı bronkoskopi, mediastinoskopi, perife-rik lenf bezi biyopsisi gibi daha invaziv yöntemlerle, invaziv girişimi kabul etmeyen diğer 10 olguya klinik radyolojik olarak (bunlardan üçü Galyum sintigrafisi ile desteklenerek) tanı konmuştu. Cilt lezyonlu 4 olgu Evre 0, 17 olgu Evre I, 19 olgu Evre 2, 2 olgu Evre 3 idi. 17/42 olgu takiplerinde cilt tutulumu dışındaki çeşitli nedenlerle (akciğer açısından klinik, fizyolojik ve radyolojik kriterlerinde kötüleşme ve/veya diğer organ tutulumları) tedavi aldı. Yalnızca cilt lezyonu olan üç olgudan ikisine lupus pernio, birine lezyonların yüzde şekil bozukluğu yapması nedeniyle steroid ve/veya klorokin tedavisi verildi.