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THROUGH THE LENS
Year : 2013  |  Volume : 4  |  Issue : 2  |  Page : 163-164  

Erythematous, firm, papular lesions over the face


Department of Skin and V. D., Civil Hospital, Ahmedabad, Gujarat, India

Date of Web Publication17-Apr-2013

Correspondence Address:
Bela J Shah
Room No.139, 1st Floor, Skin OPD, Civil Hospital, Ahmedabad, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.110648

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How to cite this article:
Shah BJ, Mangal S. Erythematous, firm, papular lesions over the face. Indian Dermatol Online J 2013;4:163-4

How to cite this URL:
Shah BJ, Mangal S. Erythematous, firm, papular lesions over the face. Indian Dermatol Online J [serial online] 2013 [cited 2019 Jul 18];4:163-4. Available from: http://www.idoj.in/text.asp?2013/4/2/163/110648

A 63-year-old female presented with a history of multiple asymptomatic, erythematous, non-indurated papules and plaques on the upper lip, below the nose, above the medial end of both eyebrows, and in front of both the ears, of 5 years duration [Figure 1] and [Figure 2]. The patient denied of having any other symptoms of itching, photosensitivity, chest pain, weight loss, and was otherwise in good health. Her baseline investigations were within normal limits and chest X-ray showed bilateral hilar lymphadenopathy. A skin biopsy was done from the face, which showed epitheloid cell granulomas in the dermis [Figure 3] and [Figure 4].
Figure 1: Multiple erythematous firm papular lesions

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Figure 2: Closer view demonstrates the lesional morphology

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Figure 3: Histopathologic photograph in low power

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Figure 4: Better visualization in 100×

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   Discussion Top


Sarcoidosis is a multi-system disease characterized by epitheloid cell tubercles without caseation although fibrinoid necrosis may be present at the center of few, proceeding either to resolution or to conversion of epitheloid tubercles into hyaline fibrous tissue. [1]

Between 20 and 35% of patients with systemic sarcoidosis have skin lesions, but cutaneous sarcoidosis can also occur in the absence of systemic involvement. [2],[3]

Recognition of cutaneous lesions is important because they provide a visible clue to the diagnosis and are an easily accessible source of tissue for histologic examination. [4] Because lesions can exhibit many different morphologies, cutaneous sarcoidosis is known as one of the "great imitators" in dermatology. [3] Specific manifestations include papules, plaques, lupus pernio, scar sarcoidosis, and rare morphologies suchas alopecia, ulcers, hypopigmented patches, and ichthyosis. [5],[6] Treatment of cutaneous lesions can be frustrating. The most effective treatment for patients with severe lesions or widespread is systemic corticosteroids.

 
   References Top

1.Scadding JG, Mitchell DN, editors. Sarcoidosis. 2 nd ed. London: Chapman and Hall; 1985. p. 1-12.  Back to cited text no. 1
    
2.Kerdel FA, Moschella SL. Sarcoidosis; an updated review. J Am Acad Dermatol 1984;11:1-19.  Back to cited text no. 2
    
3.Samtsov AV. Cutaneous sarcoidosis. Int J Dermatol 1992;31:385-91.  Back to cited text no. 3
    
4.Katta R. Cutaneous sarcoidosis: A dermatologic masquerader. Am Fam Physician 2002;65:1581-4.  Back to cited text no. 4
    
5.Mana J, Marcoval J, Graells J, Salazar A, Peyri J, Pujol R. Cutaneous involvement in sarcoidosis. Relationship to systemic disease. Arch Dermatol 1997;133:882-8.  Back to cited text no. 5
    
6.Sharma OP. Sarcoidosis of the skin. In: Freed-Berg IM, Fitzpatrick TB, editors. Fitzpatrick's Dermatology in General Medicine. 5th ed. New York: McGraw-Hill; 1999. p. 2099-106.  Back to cited text no. 6
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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