Die Sarkoidose als Systemerkrankung

[Under the skin-A special manifestation of a systemic granulomatous disease]

Based on the case of a 33-year-old female patient with Löfgren's syndrome and skin changes in the region of a tattoo, this article describes tattoo sarcoidosis as a special manifestation of cutaneous sarcoidosis. Papulonodular changes that are strictly confined to a tattoo are highly suspicious for tattoo sarcoidosis. Interestingly, tattoo sarcoidosis is commonly associated with the involvement of other organs.

Sarcoidosis and autoimmune diseases: differences, similarities and overlaps

PURPOSE OF REVIEW

Sarcoidosis is a rare, multisystem granulomatous disease of incompletely understood pathogenesis. Clinically, it shares common features with several systemic and organ-specific autoimmune diseases, although known autoantibodies or useful serologic markers for diagnosis and monitoring of disease activity are lacking. Sarcoidosis can both coexist with or mimic connective tissue diseases or vasculitis. Here, we review possible common etiologic factors between sarcoidosis and autoimmune disease, comparing clinical, laboratory and imaging features.

RECENT FINDINGS

Autoimmune diseases may precede or follow the diagnosis of sarcoidosis. Overall, the prevalence of both co-existing is unknown because of limited evidence. The presence of autoantibodies in sarcoidosis should raise suspicion of an underlying autoimmune disease that mimics or co-occurs with sarcoidosis. Silica dust exposure has been associated with an increased prevalence of both sarcoidosis and rheumatoid arthritis. In another study, autoimmune thyroid disease, Sjogren's syndrome and ankylosing spondylitis have been reported to be more frequent in sarcoidosis compared with healthy controls.

SUMMARY

A systematic diagnostic work-up is necessary to detect overlapping disease features in patients with sarcoidosis. Immune-modulating therapies need to be taken into account as these can induce paradoxical reactions.