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Reticular Dermis01:15

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The papillary and reticular dermis are the two layers of the dermis. They are made of connective tissue with fibers of collagen extending from one to the other, making the border between the two somewhat indistinct. The dermal papillae extending into the epidermis belong to the papillary layer, whereas the dense collagen fiber bundles below belong to the reticular layer.
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Dermoscopy Aids in the Diagnosis of Discoid Lupus Erythematosus
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[Livedo-like cutaneous sarcoidosis].

S Duboys1, V Cante1, C Monégier du Sorbier1

  • 1Service de dematologie, CHU de Poitiers, 2, rue de la Milétrie, 86021 Poitiers, France.

Annales De Dermatologie Et De Venereologie
|March 19, 2016
PubMed
Summary

Livedo, a skin condition, can be an early sign of systemic sarcoidosis. Doctors may use lab tests to screen for sarcoidosis when patients present with unusual livedo.

Keywords:
Granulome périvasculaireLivedoLivédoPerivascular granulomaSarcoidosisSarcoïdose

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Area of Science:

  • Dermatology
  • Internal Medicine
  • Pathology

Background:

  • Cutaneous sarcoidosis presents with diverse clinical manifestations.
  • Livedo reticularis is an uncommon but recognized dermatological sign.

Observation:

  • A 51-year-old female presented with bilateral knee livedo, polyarthralgia, malaise, weight loss, and dyspnea.
  • Skin biopsy showed granulomas around dermal vessels; lab tests revealed elevated angiotensin-converting enzyme, mediastinal adenomegaly, and pulmonary fibrosis.
  • The patient developed hepatic involvement and hypercalcemia, consistent with systemic sarcoidosis.

Findings:

  • Systemic sarcoidosis was diagnosed based on clinical and laboratory findings.
  • Treatment with systemic corticosteroids led to favorable outcomes, including laboratory normalization and symptom resolution.
  • Histopathology suggests granuloma formation around arterioles contributes to livedo.

Implications:

  • Livedo reticularis can be a presenting sign of systemic sarcoidosis.
  • Screening for sarcoidosis should be considered in cases of atypical livedo.
  • This case highlights the importance of recognizing cutaneous manifestations of systemic diseases.