Megan Isaac-Renton, Sanjay Siddha. UBCMJ 2011 2(2):42-44.
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ABSTRACT
A 57-year-old African-American woman with pulmonary sarcoidosis presented to the emergency room with a large solitary violaceous plaque on her right lower leg. The lesion, initially diagnosed as cellulitis, was ultimately diagnosed as interstitial cutaneous sarcoidosis. Classically, sarcoidosis is characterized histologically by non-caseating granulomas with a paucity of inflammatory cells (“naked granulomas”); however, in 16–20% of cases, an interstitial histocytic pattern is noted under the microscope. Various treatment regimens have been described for cutaneous sarcoidosis, including the use of tetracycline and its derivatives. The patient described in this report was treated with oral minocycline (Minocin®) and topical clobetasol propionate (Dermovate®) ointment, with significant improvement in both the appearance and symptomatology of the lesion.
A 57-year-old African-American woman with pulmonary sarcoidosis presented to the emergency room with a large solitary violaceous plaque on her right lower leg. The lesion, initially diagnosed as cellulitis, was ultimately diagnosed as interstitial cutaneous sarcoidosis. Classically, sarcoidosis is characterized histologically by non-caseating granulomas with a paucity of inflammatory cells (“naked granulomas”); however, in 16–20% of cases, an interstitial histocytic pattern is noted under the microscope. Various treatment regimens have been described for cutaneous sarcoidosis, including the use of tetracycline and its derivatives. The patient described in this report was treated with oral minocycline (Minocin®) and topical clobetasol propionate (Dermovate®) ointment, with significant improvement in both the appearance and symptomatology of the lesion.
KEYWORDS: cutaneous sarcoidosis, cutaneous infection, necrobiosis lipoidica, granuloma annulare, minocycline, clobetasol propionate