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2011 | 6 | 4 | 480-482

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A middle-age woman with subcutaneous plaque and hilar adenopathies


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Subcutaneous sarcoidosis (SS) is an unusual and specific subtype of nodular sarcoidosis 1. The presence of SS with no elements of systemic manifestations is a rare condition: it is reported only in 1.4% to 6% of patients with systemic sarcoidosis, with the trunk being the most predilected area. Such cases with rare presentation are challenging for physicians because it can mimic several chronic infections, amyloidosis, hypothyroidism, lysosomal storage diseases and other conditions. Typical imaging (specially bilateral hilar adenopathies), histological exam and laboratory findings are the baseline to establish the diagnosis of sarcoidosis. In our case, the presence of subcutaneous manifestations avoided the performance of invasive procedures to get confirmation from other target organs: The epithelioid cells granulommas in subcutaneous fat and the representative radiological images were enough features to make the certain diagnosis. The first-line therapy for SS is oral steroids (20–40 mgr/day) with responses observed only 4–8 weeks after initiation of the treatment2. Prognosis of SS is good with spontaneous remission in some cases; however, when granulommas or fibrosis involves vital organs sarcoidosis can be life-threatening. Physicians should consider diagnosis of SS in patients with clinical suspicious history as sometimes skin manifestations are the first sign of systemic presentation of disease










Physical description


1 - 8 - 2011
1 - 6 - 2011


  • San Cecilio University Hospital, 18012, Granada, Spain
  • Unit of Systemic Diseases, San Cecilio University Hospital, 18012, Granada, Spain
  • Unit of Systemic Diseases, San Cecilio University Hospital, 18012, Granada, Spain


  • [1] Rodríguez-Lojo R, Almagro M, Barja JM et al. Subcutaneous Sarcoidosis during Pegylated Interferon Alfa and Ribavirin Treatment for Chronic Hepatitis C. Dermatol Res Pract. 2010;2010:230417.
  • [2] Marcoval J, Moreno A, Mañá J, Peyri J. Subcutaneous sarcoidosis. Dermatol Clin. 2008 Oct;26(4):553–556. http://dx.doi.org/10.1016/j.det.2008.05.003[Crossref][WoS]
  • [3] Bosnić D, Baresić M, Bagatin D, Ilić I. Subcutaneous sarcoidosis of the face. Intern Med. 2010;49(6):589–592 http://dx.doi.org/10.2169/internalmedicine.49.2930[Crossref][WoS]
  • [4] Nishiyama Y, Yamamoto Y, Fukunaga K, Takinami H, Iwado Y, Satoh K, Ohkawa M.Comparative evaluation of 18F-FDG PET and 67Ga scintigraphy in patients with sarcoidosis. J Nucl Med. 2006 Oct;47(10):1571–1576.
  • [5] Ainslie GM, Benatar SR. Serum angiotensin converting enzyme in sarcoidosis: sensitivity and specificity in diagnosis: correlations with disease activity, duration, extra-thoracic involvement, radiographic type and therapy. Q J Med. 1985 Jun;55(218):253–270.
  • [6] Marcoval J, Mana J, Moreno A, Peyri J. Subcutaneous sarcoidosis clinicopathological study of 10 cases. Br J Dermatol 2005;153:790–794. http://dx.doi.org/10.1111/j.1365-2133.2005.06815.x[Crossref]

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