|Year : 2017 | Volume
| Issue : 2 | Page : 153-154
SkIndia Quiz 34: Asymptomatic swelling over an old forehead scar
Pravesh Yadav, Preksha Singh, Ram Chander
Department of Dermatology and Sexually Transmitted Diseases, Sucheta Kriplani Hospital, Lady Hardinge Medical College, Delhi, India
|Date of Web Publication||16-Mar-2017|
RZ-97, Phase-III, Prem Nagar, Najafgarh, New Delhi - 110 043
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Yadav P, Singh P, Chander R. SkIndia Quiz 34: Asymptomatic swelling over an old forehead scar. Indian Dermatol Online J 2017;8:153-4
|How to cite this URL:|
Yadav P, Singh P, Chander R. SkIndia Quiz 34: Asymptomatic swelling over an old forehead scar. Indian Dermatol Online J [serial online] 2017 [cited 2017 Apr 26];8:153-4. Available from: http://www.idoj.in/text.asp?2017/8/2/153/198809
A 25-year-old man presented with an asymptomatic slowly progressive swelling over the forehead for the past three months. He gave a history of trauma at the same site at 5 years of age that healed leaving behind a linear scar. There were no lesions elsewhere in the body. There was no history of pain, itching, discharge, or ulceration over the scar. There was no history of breathlessness on exertion, eye complaints, joint pain, fever, weight loss, or loss of appetite.
Cutaneous examination revealed a single circumscribed, skin-colored, firm, nontender nodule of size 2 × 2 cm on the left side of the forehead underlying a linear, dark brown-colored, depressed scar of size 1.5 × 0.5 cm. The nodule was not adherent to the underlying bone. No regional lymphadenopathy was appreciated [Figure 1].
|Figure 1: Single circumscribed, skin-colored, nontender nodule of size 2 × 2 cm, on the left side of the forehead underlying a linear dark brown depressed scar of size 1.5 × 0.5 cm|
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Hematological examination, liver and kidney function tests, radiographs of chest and skull, Mantoux test, serum ACE levels, and ophthalmologic examination were within normal limits.
Histopathologic examination revealed a normal epidermis with the deep dermis showing presence of numerous noncaseating epitheloid cell naked granulomas lying back to back and reaching up to the subcutis. Asteroid bodies were seen in a few cells [Figure 2] and [Figure 3]. Ziehl–Neelsen, Fite–Faraco, and periodic acid-Schiff stains revealed no organism.
|Figure 2: Photomicrograph showing numerous noncaseating epitheloid cell naked granulomas and multinucleate gaint cells lying back to back and reaching up to the subcutis. (hematoxylin and eosin, ×10)|
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|Figure 3: High-power view showed noncaseating epitheloid cell naked granulomas with asteroid bodies. (hematoxylin and eosin, ×100)|
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| What Is the Diagnosis?|| |
| References|| |
Braverman IM. Sarcoidosis. In: Feedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz SI, editors. Fitzpatrick's Dermatology in General Medicine. 6th
ed. New York: McGraw Hill; 2003. p. 1777-83.
Kerdel FA, Moschella SL. Sarcoidosis: An updated review. J Am Acad Dermatol 1984;11:1-19.
Mañá J, Marcoval J, Graells J, Salazar A, Peyrí J, Pujol R. Cutaneous involvement in sarcoidosis. Relationship to systemic disease. Arch Dermatol 1997;133:882-8.
Caro I. Scar sarcoidosis. Cutis 1983;32:531-3.
Katta R. Cutaneous sarcoidosis: A dermatologic masquerader. Am Fam Physician 2002;65:1581-4.
Minus HR, Grimes PE. Cutaneous manifestations of sarcoidosis in blacks. Cutis 1983;32:361-3, 372.
Bachelez H, Senet P, Cadranel J, Kaoukhov A, Dubertret L. The use of tetracyclines for the treatment of sarcoidosis. Arch Dermatol 2001;137:69-73.
[Figure 1], [Figure 2], [Figure 3]