Psoriasiform sarcoidosis associated with depigmentation

Area of Science:

• Dermatology
• Internal Medicine
• Pathology

Background:

• Cutaneous sarcoidosis presents with varied clinical manifestations.
• Systemic involvement can accompany skin lesions, affecting organs like the liver and salivary glands.
• Angiolupoid, lupus pernio, and verrucous plaques are among the diverse presentations of cutaneous sarcoidosis.

Purpose of the Study:

• To report a rare case of a 65-year-old female with multiple types of cutaneous sarcoidosis.
• To document associated systemic manifestations, including hepatomegaly and parotid gland swelling.
• To illustrate the diagnostic process and treatment response in a complex sarcoidosis case.

Main Methods:

• Clinical examination to identify diverse cutaneous lesions.
• Assessment for systemic involvement, including organomegaly and specific symptoms.
• Histopathological analysis for non-caseating epithelioid cell granulomas with giant cells.
• Monitoring patient response to corticosteroid therapy.

Main Results:

• The patient presented with psoriasiform, depigmented, angiolupoid, lupus pernio, papular, and verrucous plaque sarcoidosis.
• Systemic involvement included hepatomegaly, bilateral parotid gland swelling, hand pain, weakness, and atrophic rhinitis.
• Histopathology confirmed non-caseating epithelioid cell granulomas, establishing the diagnosis.
• The patient demonstrated a favorable response to 10 mg of daily prednisolone.

Conclusions:

• Cutaneous sarcoidosis can exhibit a wide spectrum of clinical presentations.
• Early diagnosis and appropriate treatment, such as with prednisolone, are crucial for managing systemic and cutaneous sarcoidosis.
• This case underscores the importance of comprehensive evaluation for systemic disease in patients with diverse skin manifestations.