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Atraumatic forearm swelling in a patient with poorly controlled asthma
Matthew Leon1, Robert Liotta2, Shambhu Aryal3
1Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Respiratory Medicine Case Reports
|August 17, 2021
Summary
This case study highlights rare sarcoidosis presenting with isolated forearm swelling before pulmonary signs. Early suspicion is crucial for diagnosing this unusual manifestation of sarcoidosis.
Area of Science:
- Pulmonology
- Dermatology
- Rheumatology
Background:
- Sarcoidosis is a multisystem inflammatory disease.
- Pulmonary involvement is the most common presentation.
- Extremity manifestations are less common and often occur after pulmonary disease.
Observation:
- A 65-year-old male with asthma presented with unilateral forearm and hand swelling.
- Initial chest imaging over many years showed no signs of sarcoidosis.
- Swelling in the left extremity preceded typical pulmonary findings.
Findings:
- Diagnosis was confirmed by histopathology of subcutaneous, dermal, and mediastinal lymph nodes.
- This case represents an unusual presentation of sarcoidosis.
- Isolated extremity findings occurred before characteristic pulmonary manifestations.
Implications:
- Highlights the importance of considering sarcoidosis in cases of unexplained extremity swelling.
- Emphasizes the need for a high index of suspicion for sarcoidosis, even with atypical presentations.
- Suggests that cutaneous and soft tissue sarcoidosis can precede pulmonary involvement.
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