Lichenoid Sarcoidosis with Myocardial Involvement

Harari, Z.; Feinstein, Abraham; Schewach-Millet, M

doi:10.1159/000251944

Cited by 3 publications

(2 citation statements)

References 5 publications

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“…[16][17][18][19][20][21][22] Clinically, the lichenoid type presents with multiple 1-to 3-mm, dome-shaped erythematous or skin-colored, slightly scaling maculopapules involving an extensive area of the skin. They occur singly or in groups, especially localized on the trunk, limbs, and face.…”

Section: Discussionmentioning

confidence: 99%

Lichenoid Sarcoidosis: A Case With Clinical and Histopathological Lichenoid Features

Garrido-Ruiz¹,

Enguita-Valls²,

Arriba³

et al. 2008

The American Journal of Dermatopathology

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Sarcoidosis is a chronic multisystemic granulomatous disease of unknown etiology, characterized by the formation of noncaseating granulomas in the involved organs. Cutaneous involvement is about 25% with different clinical expressions, the lichenoid pattern being one of the rarest types of cutaneous sarcoidosis. Lichenoid sarcoidosis clinically manifests with multiple scale papules involving extensive skin areas, especially the trunk, limbs, and face mimicking a lichen planus. Although diverse histologic patterns have been previously related, a lichenoid granulomatous infiltrate involving the dermo-epidermal junction has never been reported in lichenoid sarcoidosis. We report a case of a 43-year-old woman presenting with skin-colored pruritic papules, slightly scaling in trunk, extremities, and ears. These symptoms condition continued to expand and worsen for several years. The patient was otherwise in good health with no lymphadenopathies. Histopathologic examination of a skin biopsy showed an upper dermal granulomatous infiltrate of epithelioid cells, without necrosis, distributed in a lichenoid pattern with many cytoid bodies. We consider this may be the first case presenting a characteristic microscopic granulomatous lichen-like pattern in the setting of a clinically lichenoid type of sarcoidosis.

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Section: Discussionmentioning

confidence: 99%

Lichenoid Sarcoidosis: A Case With Clinical and Histopathological Lichenoid Features

Garrido-Ruiz¹,

Enguita-Valls²,

Arriba³

et al. 2008

The American Journal of Dermatopathology

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“…The lichenoid variant of sarcoidosis is one of the rare specific cutaneous lesions of sarcoidosis that represent a variant of papular sarcoidosis and accounts for 1–2% of all cutaneous sarcoidosis cases . Clinically, lichenoid sarcoidosis presents with discrete or grouped, flat‐topped or dome‐shaped, erythematous or skin‐colored, slightly scaly papules resembling lichen planus.…”

Section: Discussionmentioning

confidence: 99%

Lichenoid papules in the periorbital area

et al. 2019

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A 50-year-old female with a 4-year history of pulmonary and cutaneous sarcoidosis presented with a recent onset of lichenoid, pruritic, slightly scaly papules on both upper lids and infraorbital skin with progressive course (Figs. 1a,b). She reported only partial improvement of the chest symptoms and original cutaneous lesions on systemic steroids with few residual erythematous papules on the nose (Fig. 1c). However, she reported being noncompliant on treatment during the last 2 years. A new chest CT scan was ordered. It revealed multiple enlarged mediastinal lymph nodes with a pattern of affection suggesting sarcoidosis (Fig. 1d). Serum calcium and 24-hour urinary calcium were normal as well as ANA and ENA panel.The patient gave no history of use of any topical agents on her eyelids and was not on any other systemic medication around the time of onset of the eruption.

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Cardiac sarcoidosis: Diagnostic, prognostic, and therapeutic considerations

Sekiguchi

Yazaki

Isobe

et al. 1996

Cardiovasc Drug Ther

151

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Cardiac involvement in patients with sarcoidosis is an important consideration for those who are concerned with this strange disease. Sarcoidosis is not an acute malignant disease but may be noticed at the time of sudden, expected death as fatal myocardial sarcoidosis at autopsy. Even with modern advances in our ability to diagnose heart disease, cardiac sarcoidosis is still often overlooked because of its subclinical disease progression. In view of this, an extensive review of previously published literature and of our own case analyses has been carried out because of the authors' long-term experience with performing Konno's endomyocardial biopsy, which was originally developed in 1962 at the author's institution. However, the sensitivity of endomyocardial biopsy in detecting sarcoid granuloma is low (20-30%), and, instead, various kinds of nongranulomatous pathologies are often seen. During the course of our research it was found that there might exist a racial difference in cardiac sarcoidosis. Cardiac death was much more frequent in Japanese patients. The possibility that heart disease in sarcoidosis is caused by cor pulmonale due to advanced pulmonary fibrosis should be reevaluated because only a limited amount of background data is available. The author's review clarified the fact that cardiac sarcoidosis is caused by myocardial or pericardial involvement, resulting in various kinds of bradyarrhythmias or tachyarrhythmias and/or congestive heart failure. Electrocardiographic (ECG) and Holter monitor readings provide a simple and effective method for early detection of this disease. The incidence of ECG abnormalities in a total of 963 sarcoidosis patients was 22.1%, which was more frequent than that of the sex- and age-matched healthy control subjects (17.9%; p < 0.025). Echocardiography and radionuclide studies also provide useful clinical information. Careful follow-up and early corticosteroid administration followed by small maintenance doses may prevent the progression of the disease and improve prognosis. Owing to the progress in antiarrhythmic drugs and pacemaker implantation, the primary cause of death in cardiac sarcoidosis has changed from sudden death (1976 report) to congestive heart failure (1985 report).

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Lichenoid Sarcoidosis with Myocardial Involvement

Abstract: A case of systemic, progressive sarcoidosis with a specific histology of skin and lymph node, a positive Kveim test and a typical radiograph of the lungs, as well as good evidence of specific myocardial involvement is presented.

Cited by 3 publications

References 5 publications

Lichenoid Sarcoidosis: A Case With Clinical and Histopathological Lichenoid Features

Lichenoid Sarcoidosis: A Case With Clinical and Histopathological Lichenoid Features

Lichenoid papules in the periorbital area

Cardiac sarcoidosis: Diagnostic, prognostic, and therapeutic considerations

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