Lichenoid Sarcoidosis: A Case With Clinical and Histopathological Lichenoid Features

“Lichenoid Granulomatous Pattern” in a Case of Lupus Vulgaris

Lupus vulgaris is a one of the most common skin infections in the Indian subcontinent. Even today, it often creates a diagnostic dilemma for both clinicians and histopathologists. We describe a case of lupus vulgaris that showed lichenoid granulomatous inflammation in the dermis. This pattern is not uncommon, but is rarely described in the literature as newer modalities currently take precedence in diagnosis. Our aim is to make clinicians and dermatopathologists aware of this pattern of inflammation seen in this common infection.

A Rare Case of Lichenoid Sarcoidosis Mimicking Papular Amyloidosis

Cutaneous lesions in sarcoidosis are seen in nearly 20–30% and include lesions like papules, nodules, plaques, infiltrated scars, and erythema nodosum. Lichenoid variants of cutaneous sarcoidosis, a type of papular variant is quite rare. Herein we report a case of lichenoid sarcoidosis in a 40-year-old male who presented with raised itchy lesions over his legs and lower back of 8 years duration.

Lichenoid reaction with granulomatous stomatitis: A retrospective histologic study of 47 patients

OBJECTIVES

Lichenoid granulomatous reaction can be subcategorized into lichenoid granulomatous dermatitis or lichenoid granulomatous stomatitis. It is described in the literature as demonstrating a band-like lichenoid infiltration with clusters of histiocytic or granuloma formation. In this study, we presented a large case series of lichenoid granulomatous stomatitis including demographics, histological features, and subcategories and compared findings with current literature.

METHODS AND MATERIALS

We retrieved all cases diagnosed with lichenoid reaction with granulomatous inflammation between January 1, 2000, and August 1, 2016, from the University of Florida Oral Pathology Biopsy Service Archives.

RESULTS

A total of 47 patients with tissue from 50 biopsy sites were included. The majority of the cases were noted in females (64%) with a mean age of 59 years (range 30-88). Most patients were Caucasian, and the most common sites in descending order were: gingiva, buccal mucosa, vestibule, tongue, lip, palate, and occasional multifocal involvement. Clinical impressions by the treating clinicians included leukoplakia, dysplasia, carcinoma in situ, squamous cell carcinoma, lichen planus, vesiculobullous disease, trauma, and allergy. The histologic features of these cases ranged from lichenoid mucositis with numerous aggregates of histiocytes to well-formed granulomas, in accordance with previous classifications of similar dermatologic lesions. All cases revealed positive CD 68 in the histiocytic infiltrates and were negative for microorganisms utilizing acid-fast bacilli, Grocott methenamine-silver, and periodic acid-Schiff stains.

CONCLUSION

Lichenoid granulomatous disease may be more common than previously reported; however, its etiology remains unknown and patients should be kept under long-term clinical follow-up.

Cutaneous Sarcoidosis in a patient with left Hilar calcification of the lungs - A Case Report

Sarcoidosis is an acquired idiopathic granulomatous disease, which is characterized by noncaseating epithelioid granulomas in organs and tissues. Most frequently it affects the lungs, liver, lymph nodes, skin, eyes and other organs. The cutaneous lesions appear in 20 - 30% of patients with systemic manifestations, and in 25% of them they appear without systemic manifestations. Based on the histopathological characteristics, cutaneous lesions are divided into specific, characterized by cutaneous granuloma, and non-specific, which are not granulomatous. Moreover, they can be classified as typical and atypical. We are presenting a female patient with unilateral hilar calcification of the lungs, who exhibited plaque skin lesions typical for sarcoidosis, with a specific granulomatous histology and a favorable response to corticosteroid and antimalarial therapy.

[Cutaneous manifestations of sarcoidosis]

Sarcoidosis is a systemic granulomatous disorder of unknown aetiology. Its dermatological manifestations are extremely polymorphous. They are normally classed as either specific lesions, comprising granulomas, which are generally chronic, or non-specific lesions, principally acute erythema nodosum. These signs are seen in around 25% of sarcoidosis patients. The disease may be heralded by a skin disorder. Diagnosis of cutaneous sarcoidosis provides the clinician with three problems: screening for a visceral site of the disease, determination of the prognosis, and long-term management with regular monitoring coupled with suitable therapy in the event of cosmetic or functional impairment.

Giant verrucous nodules in a patient with tuberculosis

Sarcoidosis is a systemic inflammatory disorder characterized histologically by noncaseating granulomas in affected organs. Cutaneous manifestations of the disease such as papules, nodules, plaques, and ulcerations occur in approximately 25% of the patients. Sarcoidosis can present with multiple different morphologies including annular, psoriasiform, ichthyosiform, morpheaform, and verrucous. In this study, we report a 30-year-old African American man with a history of spinal tuberculosis as a child and slowly enlarging verrucous nodules that appeared at the age of 5 years. After an extensive infectious disease evaluation, the diagnosis of verrucous sarcoidosis was established with the presence of noncaseating granulomas and a completely negative workup for infectious etiologies.