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[Positive tuberculin reaction in sarcoidosis]
A Pfau1, T Abd-el-Raheem, M Landthaler
1Dermatologische Klinik und Poliklinik, Universität, Regensburg.
Summary
Scar sarcoidosis, a rare skin condition, can occur with pulmonary sarcoidosis. A positive tuberculin test in this case did not rule out sarcoidosis, and allopurinol showed promising results for both skin and lung symptoms.
Area of Science:
- Dermatology
- Pulmonology
- Immunology
Background:
- Scar sarcoidosis is an uncommon presentation of sarcoidosis.
- Cell-mediated immunity assessment often involves tuberculin and recall antigen tests.
- Sarcoidosis diagnosis typically considers clinical findings and immunological data.
Observation:
- A 68-year-old woman presented with scar sarcoidosis and pulmonary sarcoidosis.
- She exhibited a strongly positive tuberculin reaction, despite exclusion of active tuberculosis and prior BCG vaccination.
- This finding highlights that a positive tuberculin test is unusual but does not exclude sarcoidosis.
Findings:
- The patient's scar and pulmonary sarcoidosis showed significant improvement.
- Treatment with allopurinol, based on limited case reports, was associated with these positive outcomes.
- Allopurinol was well-tolerated by the patient.
Implications:
- A positive tuberculin test should not preclude a sarcoidosis diagnosis.
- Allopurinol represents a potential therapeutic option for managing cutaneous and pulmonary sarcoidosis.
- Further clinical trials investigating allopurinol for sarcoidosis are warranted due to its tolerability and efficacy.