Ann Dermatol.  2012 Feb;24(1):74-76. 10.5021/ad.2012.24.1.74.

Cutaneous Sarcoidosis Clinically Mimicking Necrobiosis Lipoidica in a Patient with Systemic Sarcoidosis

• Chiba T
• Takahara M
• Nakahara T
• Fukagawa S
• Takei K
• Shono A
• Kiryu H
• Moroi Y
• Furue M

• KMID: 2156860
• DOI: http://doi.org/10.5021/ad.2012.24.1.74

Abstract

A 70-year-old woman with an 8-year history of systemic sarcoidosis developed round, red-brown eruptions, with central atrophic lesions on her lower legs. The features of the biopsy specimen resembled those of necrobiosis lipoidica (NL), but although necrobiosis was present there were well-formed non-necrotizing granulomas in the dermis. The histological diagnosis was cutaneous sarcoidosis. Systemic sarcoidosis presenting with NL has rarely been reported. The histological features of cutaneous sarcoidosis sometimes mimic those of other granulomatous diseases, including NL and granuloma annulare, which are difficult to distinguish. We discuss the novel association between sarcoidosis and other granulomatous diseases.

Keyword

Granuloma; Necrobiosis lipoidica; Sarcoidosis

MeSH Terms

Aged
Biopsy
Dermis
Female
Granuloma
Granuloma Annulare
Humans
Hydrazines
Leg
Necrobiosis Lipoidica
Necrobiotic Disorders
Sarcoidosis
Hydrazines

Figure

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  Fig. 1 Necrobiosis lipoidica-like skin lesions on both shins.

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  Fig. 2 Histopathology of the left shin skin lesion biopsy showed degeneration of collagen fibers in the dermis surrounded by inflammatory cells (H&E, ×40).

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  Fig. 3 High-power image shows epithelioid-cell granuloma formation around the dermal collagen degeneration (H&E, ×200).

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  Fig. 4 Alcian blue staining reveals mucin deposits within the area of collagen degeneration (×40).

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