Perineural granulomas in cutaneous sarcoidosis have been rarely reported and their clinical significance has yet to be evaluated. Recently, a 27-year-old male presented with multiple pink papules on the flank and lower back, accompanied by a painful, burning sensation. Biopsies revealed well-defined granulomas, consistent with sarcoidosis, in the dermis and involving small cutaneous nerves. We hypothesized that perineural granulomas may be an under-recognized feature of cutaneous sarcoidosis and may be responsible for sensory disturbances. We reviewed cases from 29 consecutive patients with cutaneous sarcoidosis. Perineural granulomas were identified in 18/29 (62%) patients and in 22/40 (55%) biopsies. Perineural granulomas were identified in 7/9 biopsies from the proximal upper extremity, 1/3 from the distal upper extremity, 7/12 from the head and the neck, including 4/4 from the nose, 5/9 from the back, 1/2 from the flank and 1/1 from the proximal lower extremity and 0/4 from the distal lower extremity. The anatomical distribution is similar to sarcoidosis small-fiber neuropathy (SSFN), in which sarcoidosis patients without evident skin lesions experience sensory disturbances of unknown etiology involving the face, the proximal extremities and the trunk. Our results indicate perineural granulomas in cutaneous sarcoidosis are more common than previously appreciated, primarily involve the head, the proximal upper extremities and the back, and may be responsible for neurological manifestations.
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http://dx.doi.org/10.1111/cup.12484 | DOI Listing |
APMIS
January 2025
National Reference Center for Leprosy/Dermatological Health (CREDESH), HC-UFU/EBSERH, Uberlândia, Brazil.
This study aimed to identify laboratory factors predicting leprosy relapse (LR) after multi-drug therapy (MDT). A case-control study included 80 patients treated with MDT at a national reference center over 12 years. The Relapse Group had 40 patients who relapsed after an average of 89.
View Article and Find Full Text PDFAm J Ophthalmol Case Rep
December 2024
Casey Eye Institute, Oregon Health & Science University, 515 SW Campus Dr, Portland, OR, USA.
Purpose: We describe a case of metastatic conjunctival squamous cell carcinoma (SCC) presenting as an infectious sclerokeratouveitis in a patient with autoimmune disease.
Observations: A 63-year-old Caucasian female presented to the cornea service with a raised perilimbal scleral infiltrate, hypopyon, and corneal perforation concerning for infectious necrotizing sclerokeratoveitis. She had an ocular history of a recurrent "pyogenic granuloma" and her medical history was notable for well-controlled systemic lupus erythematosus and rheumatoid arthritis.
BMC Infect Dis
October 2024
Post-Graduation Program in Health Science, School of Medicine, Federal University of Uberlândia, Uberlândia, MG, Brazil.
Background: Treatment failure (TF) in leprosy following multidrug therapy (MDT) presents a significant challenge. The current World Health Organization (WHO) fixed-duration MDT regimen, based on lesion count, might not be adequate. Leprosy lacks clear-cut objective cure criteria, and the predictive value of post-MDT histopathological findings remains uncertain.
View Article and Find Full Text PDFHansen's disease, commonly known as leprosy, is an infectious disease caused by Mycobacterium leprae. Being rare in developed countries, it is an increasingly common imported disease due to the migratory flow from countries where it is endemic. We present the case of a 21-year-old man who went to the emergency department with complaints of additive polyarthralgia involving large joints, papules, and erythematous plaques on the limbs with bullae and central necrosis and fever with chills for one week.
View Article and Find Full Text PDFMonaldi Arch Chest Dis
September 2023
Respiratory Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan.
Leprosy is a neglected disease sporadically reported in high-income countries. Skin lesion and peripheral nerve involvement represent most common manifestations. Mediastinal lymphadenopathy in the absence of superficial lymph nodes involvement is very rare.
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