Solitary fibrous tumors of the pleura are rare neoplasms and can have giant diameters. Complete surgical resection is the optimal treatment. The risk of malignant transformation of such large masses should be borne in mind.
ÖzetBüyük taklitçilerden birisi olan kutanöz sarkoidoz hala patogenezi tam olarak anlaşılamamış ve klinikte çok farklı şekillerde karşımı-za çıkabilen bulmaca gibi bir klinik antitedir. Elli sekiz yaşında kadın hasta 35 yıl önce oluşan skarlarda 5 aydır ortaya çıkan kabarma yakınması ile polikliniğimize başvurdu. Dermatolojik muayenede farklı bölgelerdeki skarlarda kabarıklık şeklinde lineer bakır kırmızı-morumsu plaklar ve diaskopide elma jölesi bulgusu tespit edildi. Alınan punch biyopsinin histopatolojik incelemesinde non-kazeifiye multifokal granulomatöz yapılar tespit edildi. Olguya yapılan incelemeler sonucunda evre I akciğer tutulumlu kutanöz skar sarkoidozu tanısı konuldu. Başlanan topikal takrolimus tedavisi ile altıncı haftadaki kontrolde lezyonlarda belirgin gerileme gözlendi ve 5 ay sonra nüks saptanmadı. Eski skarlarda infiltrasyon ile başvuran hastalarda skar sarkoidozu akla gelmesi gereken bir tanıdır ve mutlaka histopatolojik inceleme ile doğrulanmalıdır. Benzer hastalar sistemik tutulum açısından ayrıntılı inceleme yapıldıktan sonra kutanöz sarkoidoz için literatürde genelde bildirilen sistemik kortikosteroid yerine topikal takrolimus ile güvenli ve etkili bir şekilde tedavi edilebilir. (Türk derm 2011; 45: 219-21) Anah tar Ke li me ler: Sarkoidoz, skar, takrolimus, tedavi, topikal
Sum maryAs a great imitator, sarcoidosis is a puzzling clinical entity that can present with diverse clinical pictures and its pathogenesis is still unknown. A 58-year-old woman applied to our outpatient clinic with a complaint of swelling of scars in her body present for 5 months and her scars were present for 35 years. On dermatological examination, enlargement of scars was observed in different areas of the patient's body and these were seen as linear copper red-violaceous plaques with apple-jelly sign on diascopy. Histopathological examination of a punch biopsy specimen revealed non-caseating granulomatous structures. Following detailed examinations, the case was diagnosed as having scar sarcoidosis with stage I lung involvement. Significant regression of lesions was detected at 6th week follow-up examination after commencement of topical tacrolimus treatment and there was not any relapse of the lesions after 5 months of treatment. The diagnosis of scar sarcoidosis should be remembered in cases who apply with the finding of infiltration of old scars and this diagnosis must be confirmed by using histopathological examination. Instead of using systemic corticosteroids, which is reported frequently for the treatment of cutaneous sarcoidosis in the literature, such cases can be treated safely and effectively with topical tacrolimus following a detailed examination for detection of systemic involvement. (Turk derm 2011; 45: 219-21
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