Specific cutaneous lesions in patients with systemic sarcoidosis: relationship to severity and chronicity of disease.

Specific (granulomatous) cutaneous lesions are seen in 9-37% of cases of systemic sarcoidosis, and are usually classified into maculopapules, plaques, lupus pernio (LP), scar sarcoidosis, and subcutaneous sarcoidosis. Their prognostic significance has not been fully established. To analyse the relationship between the clinical type of granulomatous cutaneous lesions and the systemic features and prognosis of systemic sarcoidosis. The clinical charts of 86 patients (19 men, 67 women, mean age 46.82 years) with systemic sarcoidosis and granulomatous cutaneous involvement followed up for > 2 years at Bellvitge University Hospital were reviewed. Cutaneous lesions developed before or at the time of diagnosis of systemic sarcoidosis in 80.23% of patients. The main cutaneous lesions were classified as maculopapules (28 patients), plaques (31), LP (6), scar sarcoidosis (7) and subcutaneous sarcoidosis (14). Erythema nodosum (EN) was seen in 30 patients. Radiological stage was 0 for 8 patients, I for 48, II for 24, III for 5 and IV for 1. Systemic sarcoidosis activity persisted for > 2 years in 47 patients, and 42 received systemic corticosteroid treatment for their disease. Maculopapular and subcutaneous sarcoidosis were mainly seen in patients with EN and radiological stage I. Plaques and LP were associated with chronic disease and requirement for systemic corticosteroids. Cutaneous granulomatous lesions are usually present at the diagnosis of systemic sarcoidosis, and the type of cutaneous involvement may have prognostic significance.

Marcoval J ，Mañá J ，Rubio M 《-》

Skin manifestations of sarcoidosis.

The skin manifestations of sarcoidosis are classified as specific, where biopsy reveals non-caseating granulomas, and non-specific, typically erythema nodosum. The most frequent specific (granulomatous) skin lesions are maculopapules, subcutaneous nodules, scar sarcoidosis, plaques and lupus pernio. Skin biopsy allows early diagnosis of sarcoidosis through a non-aggressive procedure. In sarcoidosis, erythema nodosum is usually associated with bilateral hilar lymphadenopathy on the chest radiograph, this being known as Löfgren's syndrome. Cutaneous lesions have prognostic significance. Löfgren's syndrome is usually associated with good prognosis and spontaneous resolution. Maculopapular lesions and subcutaneous nodules are more often associated with remission of the systemic disease at two years, while plaques and, mainly, lupus pernio are hallmarks of chronic disease. Most cutaneous lesions of sarcoidosis are only mildly symptomatic and do not require treatment. However, chronic skin lesions, particularly lupus pernio, are disfiguring and can have a strong psychological and social impact. Treatment of these lesions is a challenge since they do not respond well to conventional treatments. The introduction of biological agents has been an important although not definitive advance in the treatment of cutaneous sarcoidosis.

Mañá J ，Marcoval J 《-》

Cutaneous sarcoid with varied morphology associated with hypercalcaemia and renal impairment.

Miida H ，Ito M 《-》

Subcutaneous sarcoidosis--clinicopathological study of 10 cases.

Marcoval J ，Maña J ，Moreno A ，Peyri J ... -  《BRITISH JOURNAL OF DERMATOLOGY》

Foreign bodies in granulomatous cutaneous lesions of patients with systemic sarcoidosis.

Marcoval J ，Mañá J ，Moreno A ，Gallego I ，Fortuño Y ，Peyrí J ... -  《ARCHIVES OF DERMATOLOGY》