Sarcoïdose gastrique révélée par une sarcoïdose cutanée folliculaire

A rare case of follicular sarcoidosis

The article is devoted to a rare variant of skin sarcoidosis the so-called follicular sarcoidosis. According to the literature, the follicular form of sarcoidosis is extremely rare, several isolated cases are described in foreign literature, there are no publications in the russian literature. A 30-year-old female patient came to the clinic of the Military Medical Academy with a skin rash of the upper extremities, trunk and neck that lasted for one year. Anamnesis: repeated use of topical corticosteroids for the treatment with a temporary positive effect. The skin process was represented by common follicular papules; a histological examination of one of the elements revealed granulomas of the sarcoid type, which were located perifolliculary, mainly around the infundibular sections of the hair follicles. The rash resolved after a course of external corticosteroid therapy. The clinical case described by us illustrates the need for histological examination to verify the diagnosis.

Sarcoidosis Involving the Gastrointestinal Tract: Diagnostic and Therapeutic Management

Involvement of the gastrointestinal (GI) tract is an infrequent extrathoracic presentation of sarcoidosis. We reviewed 305 cases of GI involvement reported in 238 patients, in whom GI sarcoidosis was the first sign of the disease in half the cases. The disease does not affect the GI tract uniformly, with a clear oral-anal gradient (80% of reported cases involved the esophagus, stomach, and duodenum). Clinicopathological mechanisms of damage may include diffuse mucosal infiltration, endoluminal exophytic lesions, involvement of the myenteric plexus, and extrinsic compressions. Ten percent of patients presented with asymptomatic or subclinical disease found on endoscopy. The diagnosis is relevant clinically because 22% of cases reviewed presented as life threatening. In addition, initial clinical/endoscopic findings may be highly suggestive of GI cancer. The therapeutic approach is heterogeneous and included wait-and-see or symptomatic approaches, glucocorticoid/immunosuppressive therapy, and surgery. Sarcoidosis of the gut is a heterogeneous, potentially life-threatening condition that requires a multidisciplinary approach and early clinical suspicion to institute personalized therapeutic management and follow-up.