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Huang MY, Kim G, Chiu MW. Warty papules on the nose. Int J Dermatol 2022; 61:e487-e488. [PMID: 34813088 DOI: 10.1111/ijd.16015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/07/2021] [Accepted: 11/11/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Margaret Y Huang
- Department of Dermatology, Keck School of Medicine at USC, Los Angeles, CA, USA
| | - Gene Kim
- Department of Dermatology, Keck School of Medicine at USC, Los Angeles, CA, USA.,Department of Pathology, Keck School of Medicine at USC, Los Angeles, CA, USA
| | - Melvin W Chiu
- Department of Dermatology, Keck School of Medicine at USC, Los Angeles, CA, USA
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Sussman ME, Pousti BT, Grossman SK, Lee JB, Hsu S. Verrucous Sarcoidosis: A Rare Clinical Presentation of Sarcoidosis. Cureus 2021; 13:e15175. [PMID: 34178497 PMCID: PMC8216646 DOI: 10.7759/cureus.15175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Verrucous sarcoidosis is a rare cutaneous variant of sarcoidosis, an inflammatory disease characterized by non-caseating granulomas that primarily involves the lungs. The current literature on verrucous sarcoidosis is limited, with the majority of lesions presenting on the lower extremities of African American males. Here, we present two cases that highlight the unique manifestations of this uncommon cutaneous entity. The first case involves a middle-aged Hispanic woman with lesions on her arms and face, and the second case involves a middle-aged African American woman with sole facial involvement. A multi-disciplinary approach to diagnosis and treatment is required as verrucous sarcoidosis can present with clinical and histopathological features indistinguishable from infectious etiologies and has an association with pulmonary sarcoidosis. Adalimumab has demonstrated success in the treatment of verrucous sarcoidosis.
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Affiliation(s)
- Morgan E Sussman
- Department of Dermatology, Temple University, Lewis Katz School of Medicine, Philadelphia, USA
| | - Bobak T Pousti
- Department of Dermatology, University of California San Diego School of Medicine, San Diego, USA
| | - Shoshana K Grossman
- Department of Dermatology, Temple University, Lewis Katz School of Medicine, Philadelphia, USA
| | - Jason B Lee
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, USA
| | - Sylvia Hsu
- Department of Dermatology, Temple University, Lewis Katz School of Medicine, Philadelphia, USA
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Bulte CA, Clements S, Driscoll MS. Chronic verrucous plaques on bilateral lower extremities. JAAD Case Rep 2020; 7:38-40. [PMID: 33319001 PMCID: PMC7727288 DOI: 10.1016/j.jdcr.2020.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
| | | | - Marcia S. Driscoll
- Correspondence to: Marcia S. Driscoll, MD, PharmD, 419 W Redwood St, Suite 235, Baltimore, MD 21201.
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Nabli N, Gammoudi R, Aounallah A, Sriha B, Belajouza C, Denguezli M. Verrucous sarcoidosis: a diagnosis to keep in mind. Pan Afr Med J 2020; 36:228. [PMID: 33708319 PMCID: PMC7908315 DOI: 10.11604/pamj.2020.36.228.21487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 07/12/2020] [Indexed: 11/28/2022] Open
Abstract
Skin manifestations of sarcoidosis occur in up to 30% of cases, and may be the sentinel sign of the disease, with the skin being sometimes exclusively affected. While this may facilitate an early dermatologic diagnosis, heterogeneity in the cutaneous morphologies of sarcoidosis complicates recognition and affirms its reputation as a “great imitator”. Here, we present a case of a verrucous version of sarcoidosis that may be misdiagnosed because it can mimic other inflammatory and neoplastic skin disorders. Although it is a rare variant, its presence should alert clinicians to the likelihood of systemic involvement of cutaneous sarcoidosis.
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Affiliation(s)
- Nadia Nabli
- Department of Dermatology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Rima Gammoudi
- Department of Dermatology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Amina Aounallah
- Department of Dermatology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Badreddine Sriha
- Department of Anatomopathology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Colandane Belajouza
- Department of Dermatology, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mohamed Denguezli
- Department of Dermatology, Farhat Hached University Hospital, Sousse, Tunisia
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Wipf A, Wipf H, Miller D. Sweet syndrome with pseudocarcinomatous hyperplasia: A case report and review of the literature. J Cutan Pathol 2019; 46:520-527. [DOI: 10.1111/cup.13436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Angela Wipf
- Department of DermatologyUniversity of Minnesota Minneapolis Minnesota
| | - Heidi Wipf
- Department of DermatologyUniversity of Minnesota Minneapolis Minnesota
| | - Daniel Miller
- Department of DermatologyUniversity of Minnesota Minneapolis Minnesota
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Hudson AD, Klimas NK, Stetson CL. Filiform Verrucous Sarcoidosis of the Face: A Warty Report. J Cutan Med Surg 2018; 22:424-426. [PMID: 29502440 DOI: 10.1177/1203475418763590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sarcoidosis is a multisystem inflammatory condition of unknown etiology. Variability in the cutaneous features of sarcoidosis is profound, and its protean manifestations affirm the condition's designation as one of dermatology's "great mimics." Cutaneous phenotypes of sarcoidosis include but are by no means limited to ichthyosiform, alopecic, erythrodermic, angiolupoid, and verrucous variants. Verrucous sarcoidosis is an exceedingly rare manifestation, and previous reports of this phenotype are limited to 15 cases. Most cases in the extant literature presented on the extremities, with clinical features mimicking that of a common wart, or as verrucous crateriform nodules, ulcers, or cutaneous horns. Only 4 previous reports of facial verrucous sarcoidosis exist in the literature, and to our knowledge, no prior cases have demonstrated filiform lesion morphology. Here we present a case of filiform verrucous sarcoidosis in an otherwise healthy, middle-aged African American man, devoid of internal organ involvement and limited to the face, histopathologically confirmed by the presence of characteristic granulomata devoid of lymphocytic infiltrates.
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Affiliation(s)
- Andrew D Hudson
- 1 Department of Dermatology, Texas Tech Health Sciences Center, Lubbock, TX, USA
| | - Natasha K Klimas
- 1 Department of Dermatology, Texas Tech Health Sciences Center, Lubbock, TX, USA
| | - Cloyce L Stetson
- 1 Department of Dermatology, Texas Tech Health Sciences Center, Lubbock, TX, USA
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Xiong X, Ling Y, Yang K, Sun W, Su Z, Lu Y. Case of sarcoidosis presenting with symmetrical facial keratotic papules. J Dermatol 2017; 45:246-247. [PMID: 28266039 DOI: 10.1111/1346-8138.13811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Xixi Xiong
- Department of Dermatology; The First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Yuting Ling
- Department of Dermatology; The First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Ke Yang
- Department of Dermatology; The First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Weiling Sun
- Department of Dermatology; The First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Zhonglan Su
- Department of Dermatology; The First Affiliated Hospital of Nanjing Medical University; Nanjing China
| | - Yan Lu
- Department of Dermatology; The First Affiliated Hospital of Nanjing Medical University; Nanjing China
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Ruocco E, Gambardella A, Langella GG, Lo Schiavo A, Ruocco V. Cutaneous sarcoidosis: an intriguing model of immune dysregulation. Int J Dermatol 2014; 54:1-12. [PMID: 25312788 DOI: 10.1111/ijd.12566] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Sarcoidosis is a systemic granulomatous disease characterized by the presence of non-caseating granulomas. Its etiology remains obscure. A plausible hypothesis suggests that a complex interplay of host factors, infectious processes, and non-infectious environmental factors, matched with a susceptible genetic background, results in a pathway that leads to systemic granulomatous inflammation. Although presentations of sarcoidosis vary enormously, multi-organ involvement is a common feature. Cutaneous involvement occurs in about 25% of patients with protean manifestations and variable prognoses. Skin manifestations are divided into specific lesions with histopathologically evident non-caseating granulomas and nonspecific lesions arising from a reactive process that does not form granulomas. A peculiar form of cutaneous sarcoidosis is represented by sarcoidal lesions at sites of trauma that has caused scarring. The pathogenesis of scar sarcoidosis remains unknown. Scar sarcoidosis is also associated with herpes zoster infection, surgery, and tattooing. Such heterogeneous events, along with those at the sites of chronic lymphedema, thermal burns, radiation dermatitis, and vaccinations, occur on areas of vulnerable skin labeled "immunocompromised districts". Numerous options are available for the treatment of cutaneous sarcoidosis. Although corticosteroids remain the treatment of choice for initial systemic therapy, other nonsteroidal agents have proven effective and therefore useful for long-term management. Tumor necrosis factor-α antagonists such as infliximab may have a role in the treatment of cutaneous sarcoidosis, especially in refractory cases that are resistant to standard regimens. Elucidation of the relationship of sarcoidal granulomas with malignancy and immunity may facilitate a better understanding of some pathomechanisms operating in neoplastic and immunity-related disorders.
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Affiliation(s)
- Eleonora Ruocco
- Department of Dermatology, Second University of Naples, Naples, Italy
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