Presentation Clinique

Clinical Setting

F 30 ans Lésions papuleuses des extrémités prédominantes,

F 30 yo with papules on the extremities.

Genou

Knee

Biopsie

Biopsy

Trichrome

PAS - Ziehl Negatifs

Bilan clinique, IDR et Radio du Thorax, Négatifs

Clinical evaluation, PPD, Radiography negative.

Diagnostic Proposé:

Dermatite granulomateuse compatible avec une sarcoïdose

Proposed Diagnosis:

Granulomatous dermatitis consistent with sarcoidosis.

Arguments:

• Sarcoidal granulomas are discrete round to oval, and composed of epithelioid histiocytes and multinucleate giant cells which may be of either Langhans or foreign body type
• Granulomas may be present only in the superficial dermis or they may extend through the whole thickness of the dermis or subcutis
• Necrosis is not usually seen in granulomas but has been reported. Small amounts of fibrinous or granular material may be seen in some granulomas
• In most cases, the overlying epidermis is normal or atrophic.
• A diversity of clinical forms of cutaneous sarcoidosis occurs, chronic cutaneous lesions may be the only manifestation.

For more details see:

SARCOIDAL GRANULOMAS

(Ref. Skin Pathology. David Weedon, 2nd Ed. Churchill-Livingstone)