Scar Sarcoidosis: A Retrospective Investigation into Its Peculiar Clinicopathologic Presentation
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: Scar sarcoidosis (SS), a rare form of cutaneous sarcoidosis, develops from pre- existing scars. Owing to its rarity, the clinicopathologic features and its significance in clini- cal prognosis have been obscure. Objective: This study aimed to investigate clinical, laboratory and histopathologic findings and to clarify characteristics associated with the development of SS and systemic involve- ment. Methods: We retrospectively assessed clinical, laboratory and histopathologic findings of SS. Clinical factors including demographics, anatomic area, number of lesion (single, mul- tiple), presence of symptoms, latent period, injury types related to scar and the proportion of systemic involvement were investigated. Results: Of the 21 patients with SS, skin lesions appeared predominantly in females (85.7%) and in the head and neck (57.1%). The mean latent period was 163.5 months and 13 pa- tients (61.9%) had multiple lesions. Injury types were varied, with no specific type identi- fied as associated with SS. Histologically, discrete sarcoidal granulomas surrounded by densely packed collagen bundles with a thickening of numerous fibers were observed. Ten patients (47.6%) had systemic involvement and showed significantly more of the multiple lesions, longer latent period and higher level of mean serum angiotensin-converting en- zyme than those without systemic involvement. Conclusion: Various causes of scar were related to SS, but no specific injury type was iden- tified as leading to SS. Although the exact pathomechanism remains unclear, the possibil- ity of systemic involvement could be considered when the patients have multiple lesions, longstanding scars, and elevated serum angiotensin-converting enzyme.
Abstract
Background: Scar sarcoidosis (SS), a rare form of cutaneous sarcoidosis, develops from pre- existing scars. Owing to its rarity, the clinicopathologic features and its significance in clini- cal prognosis have been obscure. Objective: This study aimed to investigate clinical, laboratory and histopathologic findings and to clarify characteristics associated with the development of SS and systemic involve- ment. Methods: We retrospectively assessed clinical, laboratory and histopathologic findings of SS. Clinical factors including demographics, anatomic area, number of lesion (single, mul- tiple), presence of symptoms, latent period, injury types related to scar and the proportion of systemic involvement were investigated. Results: Of the 21 patients with SS, skin lesions appeared predominantly in females (85.7%) and in the head and neck (57.1%). The mean latent period was 163.5 months and 13 pa- tients (61.9%) had multiple lesions. Injury types were varied, with no specific type identi- fied as associated with SS. Histologically, discrete sarcoidal granulomas surrounded by densely packed collagen bundles with a thickening of numerous fibers were observed. Ten patients (47.6%) had systemic involvement and showed significantly more of the multiple lesions, longer latent period and higher level of mean serum angiotensin-converting en- zyme than those without systemic involvement. Conclusion: Various causes of scar were related to SS, but no specific injury type was iden- tified as leading to SS. Although the exact pathomechanism remains unclear, the possibil- ity of systemic involvement could be considered when the patients have multiple lesions, longstanding scars, and elevated serum angiotensin-converting enzyme.
참고문헌 (24)
- Newman LS, "Sarcoidosis", N Engl J Med, 336, pp.1224~1234 (1997)
- García-Colmenero L, "The natural history of cutaneous sarcoidosis. Clinical spectrum and histological analysis of 40 cases", Int J Dermatol, 58, pp.178~184 (2019)
- English JC 3rd, "Sarcoidosis", J Am Acad Dermatol, 44, pp.725~743 (2001)
- Collin B, "A retrospective analysis of 34 patients with cutaneous sarcoidosis assessed in a dermatology department", Clin Exp Dermatol, 35, pp.131~134 (2010)
- Veien NK, "Cutaneous sarcoidosis in Caucasians", J Am Acad Dermatol, 16(3 Pt 1), pp.534~540 (1987)
- Burgdorf WH, "Sarcoid granulomas in venipuncture sites", Cutis, 24, pp.52~53 (1979)
- Usmani N, "A case of sarcoidosis occurring within an extensive burns scar", J Plast Reconstr Aesthet Surg, 60, pp.1256~1259 (2007)
- Kormeili T, "Cutaneous sarcoidosis at sites of previous laser surgery", Cutis, 73, pp.53~55 (2004)
- Kwon SH, "Linear scar sarcoidosis on thin blepharoplasty line mimicking a hypertrophic scar : a case report", SAGE Open Med Case Rep, 6, pp.2050313~ (2018)
- Mangas C, "Clinical spectrum and histological analysis of 32 cases of specific cutaneous sarcoidosis", J Cutan Pathol, 33, pp.772~777 (2006)
- Jung YJ, "Clinical and histopathological analysis of specific lesions of cutaneous sarcoidosis in Korean patients", J Dermatolog Treat, 22, pp.11~17 (2011)
- Cardoso JC, "Cutaneous sarcoidosis : a histopathological study", J Eur Acad Dermatol Venereol, 23, pp.678~682 (2009)
- Atci T, "Scar sarcoidosis : 11 patients with variable clinical features and invariable pulmonary involvement", Clin Exp Dermatol, 44, pp.826~828 (2019)
- Tong C, "Comparison of cutaneous sarcoidosis with systemic sarcoidosis : a retrospective analysis", Int J Clin Exp Pathol, 7, pp.372~377 (2013)
- Ishak R, "Cutaneous sarcoidosis : clinicopathologic study of 76 patients from Lebanon", Int J Dermatol, 54, pp.33~41 (2015)
- Wu MC, "Cutaneous sarcoidosis in southern Taiwan : clinicopathologic study of a series with high proportions of lesions confined to the face and angiolupoid variant", J Eur Acad Dermatol Venereol, 27, pp.499~505 (2013)
- 김수정, "Scar Sarcoidosis Developed after Blepharoplasty in Acute Lymphoblastic Leukemia Patient", Annals of Dermatology, 29(4), pp.511~513 (2017), 대한피부과학회
- Mañá J, "Cutaneous involvement in sarcoidosis. Relationship to systemic disease", Arch Dermatol, 133, pp.882~888 (1997)
- Sorabjee JS, "Reactivation of old scars : inevitably sarcoid", Postgrad Med J, 81, pp.60~61 (2005)
- de Almeida HL, "Scar sarcoidosis with a 50-year interval between an accident and onset of lesions", Dermatol Online J, 14, pp.18~ (2008)
- 김형래, "Scar Sarcoidosis Induced by Pulsed Dye Laser Treatment", Annals of Dermatology, 28(4), pp.509~510 (2016), 대한피부과학회
- Callen JP, "The presence of foreign bodies does not exclude the diagnosis of sarcoidosis", Arch Dermatol, 137, pp.485~486 (2001)
- Ball NJ, "The histologic spectrum of cutaneous sarcoidosis : a study of twenty-eight cases", J Cutan Pathol, 31, pp.160~168 (2004)
- Yanardag H, "Diagnosis of cutaneous sarcoidosis; clinical and the prognostic significance of skin lesions", Multidiscip Respir Med, 8, pp.26~ (2013)