A Case of Plaque-type Cutaneous Sarcoid Preceded by Scar Sarcoidosis

Abstract

A 70-year-old man visited our hospital because of gradually enlarging erythema on the abdomen, which appeared 8 years ago without subjective symptoms. At the first visit, there was annular, confluent erythematous plaque over the lower abdomen. Also, there was an erythematous nodule on the scalp that had appeared 1 year ago at a site where he had experienced a traumatic injury 30 years ago. A histopathological examination revealed that both lesions had epithelioid cell granulomas and were diagnosed as cutaneous sarcoid. Interestingly, examination under polarized light microscopy revealed silica-like materials at the center of the granulomas in the scalp lesion, suggestive of scar sarcoidosis due to a post-traumatic scar. Therefore, we suggest that the patient's scalp lesion was preceded by the plaque-type cutaneous sarcoid in the abdomen. Sarcoidosis with multiple skin lesions may be complicated by the internal disease. A periodic whole body examination includingonset of new skin eruptions is necessary.