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Subcutaneous Sarcoidosis.

Dedeepya Gullapalli¹, Avinash Vangara¹, Sandhya Kolagatla¹

¹Internal Medicine, Appalachian Regional Healthcare, Harlan, USA.

|December 28, 2023

Summary

This summary is machine-generated.

This case report details a rare form of sarcoidosis, Darier-Roussy sarcoid, presenting as subcutaneous skin nodules. Effective treatment led to significant nodule reduction, highlighting management options for this condition.

Keywords:

cutaneous granulomatous disease cutaneous sarcoidosis disease-modifying antirheumatic drugs (dmards)hilar adenopathy steroids

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Area of Science:

Dermatology
Immunology
Pathology

Background:

Sarcoidosis is a multisystem inflammatory disease characterized by non-caseating granulomas.
Subcutaneous sarcoidosis, particularly the Darier-Roussy type, is a rare presentation involving deep skin layers.
Diagnosis requires clinical, histopathological evidence, and exclusion of other granulomatous diseases.

Observation:

A 40-year-old female presented with multiple, worsening subcutaneous skin nodules, erythema, and mild tenderness.
Histopathology revealed non-necrotizing granulomas with multinucleated giant cells in skin biopsies.
Systemic involvement of sarcoidosis was systematically ruled out.

Findings:

The patient was diagnosed with subcutaneous sarcoidosis (Darier-Roussy sarcoid).
Treatment with systemic steroids, hydroxychloroquine, methotrexate, and adalimumab was initiated.
After nine months, a clinically significant reduction in nodule size was observed.

Implications:

This case highlights the successful management of rare subcutaneous sarcoidosis with a combination therapy.
Early diagnosis and appropriate treatment are crucial for managing extensive or deforming lesions.
Further research into optimal treatment strategies for Darier-Roussy sarcoid is warranted.