J Korean Rheum Assoc.  2010 Mar;17(1):56-61. 10.4078/jkra.2010.17.1.56.

A Case of Diffuse Subcutaneous Sarcoidosis Presenting as Thickened Extremities

• Yun SE
• Kim HO
• Jeong YG
• Lee KJ
• Lee CM
• Kim JH
• Na JB
• Yoon TJ
• Lee SI

• KMID: 2201993
• DOI: http://doi.org/10.4078/jkra.2010.17.1.56

Abstract

Sarcoidosis is multi-systemic disorder of an unknown etiology, and this is histologically characterized by noncaseating granulomatous inflammation. Sarcoidosis may affect the lung, skin, lymph nodes and eyes, but it rarely affects the subcutaneous tissue. There has been no report of diffuse subcutaneous sarcoidosis in Korea. We experienced a 57-year-old female with diffuse subcutaneous sarcoidosis that presented as thickened extremities. The patient complained of edema and skin thickening on both upper extremities. Magnetic resonance imaging revealed the reticular form of sarcoidosis on the forearm and the biopsy showed noncaseating granuloma. She was finally diagnosed as diffuse subcutaneous sarcoidosis and she improved after treatment with corticosteroid. We report here on this unusual case along with a review of the relevant literature.

Keyword

Subcutaneous; Sarcoidosis; Granuloma; Corticosteroid; Magnetic resonance imaging

MeSH Terms

Biopsy
Edema
Extremities
Eye
Female
Forearm
Granuloma
Humans
Inflammation
Korea
Lung
Lymph Nodes
Magnetic Resonance Imaging
Middle Aged
Sarcoidosis
Skin
Subcutaneous Tissue
Upper Extremity

Figure

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  Fig. 1. The sagittal (A) and axial sections (B) of the Gd-DTPA enhanced T1-weighted magnetic resonance images. These images show the reticular pattern with low to intermediate signal intensity (arrows).

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  Fig. 2. The skin biopsy specimen shows many noncasating granulomas that consisted of epithelial cells, multinucleated giant cells and lymphocytes (H&E stain, ×100).

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  Fig. 3. The sagittal (A) and axial sections (B) of the Gd-DTPA enhanced T1-weighted magnetic resonance images. These images show disappearance of the reticular pattern and the decreased extent of the high signal intensity of the medial subcutaneous fat layer in the left forearm.

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