Resident Rounds: Part III – Cutaneous Sarcoidosis in a Blepharoplasty Scar

October 2015 | Volume 14 | Issue 10 | Features | 1169 | Copyright © October 2015


Nora K. Shumway MD, Lauren Snitzer MD, Habibollah Alamdari MD, and Kari Martin MD

University of Missouri School of Medicine, Department of Dermatology, Columbia, MO

table 1
Despite the many clinical scenarios of scar sarcoidosis, it is a specific cutaneous sign of sarcoidosis and is often the first presentation or present at the onset of systemic disease in 30-80% of patients.5,23 Scar sarcoidosis can be an important cutaneous manifestation; however, it is debated whether it is associated with an increased rate of systemic involvement. This association is difficult to assess due to the limited and often conflicting literature. Most reviews have been in patients already diagnosed with systemic sarcoidosis, one of which showed 40% also had scar sarcoidosis.4,5 Although frequently present at the onset of systemic sarcoidosis, systemic symptoms can be delayed by up to 3 years as seen in 30% of patients in a review from Spain, further complicating the association.25 Furthermore, skin evaluations are not usually part of a routine sarcoidosis evaluation, so cutaneous presentations could be missed.4 There are many case reports with systemic involvement in the setting of scar sarcoidosis, but this could be secondary to a reporting bias.3,9,12,16-20,24 Therefore, due to the mixed findings, it is prudent to recommend systemic evaluation to decrease any associated morbidity or mortality risk.18

DISCLOSURES

The authors have no relevant conflicts of interest.
table 2

REFERENCES

  1. Haimovic A, Sanchez M, Judson MA, Prystowsky S. Sarcoidosis: a comprehensive review and update for the dermatologist: part I. Cutaneous disease. Journal of the American Academy of Dermatology. May 2012;66(5):699 e691-618; 717-698.
  2. Baughman RP, Teirstein AS, Judson MA, et al. Clinical characteristics of patients in a case control study of sarcoidosis. AJRCCM. Nov 15 2001;164(10 Pt 1):1885-1889.
  3. Hong YC, Na DJ, Han SH, Lee YD, Cho YS, Han MS. A case of scar sarcoidosis. The Korean Journal of Internal Medicine. Dec 2008;23(4):213-215.
  4. Yanardag H, Pamuk ON, Karayel T. Cutaneous involvement in sarcoidosis: analysis of the features in 170 patients. Respiratory Medicine. Aug 2003;97(8):978-982.
  5. Marcoval J, Mana J, Rubio M. Specific cutaneous lesions in patients with systemic sarcoidosis: relationship to severity and chronicity of disease. Clinical and Experimental Dermatology. Oct 2011;36(7):739-744.
  6. Selim A, Ehrsam E, Atassi MB, Khachemoune A. Scar sarcoidosis: a case report and brief review. Cutis. Dec 2006;78(6):418-422.
  7. Ruocco E, Gambardella A, Langella GG, Lo Schiavo A, Ruocco V. Cutaneous sarcoidosis: an intriguing model of immune dysregulation. International Journal of Dermatology. Jan 2015;54(1):1-12.
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