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Sarcoidosis showing a livedo reticularis-like eruption


European Journal of Dermatology. Volume 7, Number 2, 112-4, March 1997, Cas cliniques

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Author(s) : H. Ura, S. Imakado, K. Iozumi, S. Shimada, I. Hayashi

Summary : We report a case of sarcoidosis in a 22-year-old man. A month before the first visit, mistiness in the left eye had developed and an eruption on the lower legs had appeared. The eruption then enlarged and coalesced. Chest X-ray examination revealed bilateral, hilar lymphadenopathy (BHL). Iritis was also present. His mother had been diagnosed as suffering from sarcoidosis. On examination, there were many nail-sized, erythematous areas on both lower legs, partly showing a reticular appearence because of coalescence, leaving islands of normal skin on some areas. Slight induration was felt. A biopsy specimen showed relatively small nodules scattered from the dermis to the subcutaneous fat, mainly around the sweat glands or vessels and partly containing giant cells, with no caseation necrosis. Serum angiotensin converting enzyme (ACE) level was 24.8 IU/l. The serum calcium level was within normal limits. The skin test reaction to the purified protein derivative of tuberculin was 0 x 0/7 x 7. Treatment with oral prednisolone at 20 mg/day and topical betamethasone valerate was instigated and the eruption disappeared within a week.

Keywords : livedo reticularis, sarcoidosis.

 

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