35 - Sarcoidosis Flashcards
Disease onset of sarcoidosis is most common in the _____ decade and is slightly higher in ______
Third
Women
Sarcoidosis has a higher incidence with
Greater distance from the equator
Highest prevalence of sarcoidisis is in
African American women
With the advent of penicillin, _____ has replaced syphilis as the great mimicker for dermatologists
Sarcoidosis
Sarcoidal lesions are divided into
Specific - have granulomatous inflammation
Nonspecific - reactive and do not exhibit sarcoidal granulomas
Most common presentation of sarcoidosis
Papular form
“Apple jelly”: _____ coloration
Yellow-brown
Apple jelly appearance on dermoscopy differentials
Sarcoidosis
Lupus vulgaris
Granuloma annulare
Dermoscopic findings significantly associated with cutaneous sarcoidosis
Pink homogenous background
Translucent orange areas
Fine white scaling
Scar-like depigmentation
Papular lesions most commonly occur on
Face and neck, with predilection for periorbital skin
Relatively symmetric, violaceous, indurated plaques and nodules occurring on the nose, earlobes, cheeks, and digits
Lupus pernio
Lupus pernio is associated with higher incidence of
Systemic involvement and upper respiratory tract disease
Present as persistent subcutaneous nodules preferentially on the extremities
Darier-Roussy sarcoid
Sarcoidal infiltration of the gingiva causes
Strawberry gums
Mucosal membrane sarcoidosis involving the gingiva mimicks
Wegener granulomatosis
Bilateral enlargement of the lacrimal, parotid, sublingual, and submandibular glands
Mikulicz syndrome
Main nonspecific cutaneous manifestation of sarcoidosis
Erythema nodosum
Erythema nodosum with bilateral hilar adenopathy, arthralgia, and fever
Lofgren syndrome
Most common organ involved with sarcoidosis
Lung
Most commonly affected portion of the eye in sarcoidosis
Uvea
Fever, parotid gland enlargement, facial palsy, and anterior uveitis
Heerfordt syndrome
Neurosarcoidosis has a predilection for
Base of the brain
Most common manifestation of neurosarcoidosis
Cranial neuropathies
Most frequently involved nerve in neurosarcoidosis
Facial nerve
Pink and violaceous papules and plaques with prominent telangiectasia that usually occur on the face; considered a variant of lupus pernio
Angiolupoid lesions
Activated sarcoidal macrophages have increased _____ activity which converts inactive to the active form of vitamin D
1 alpha-hydroxylase
Renal sarcoidosis results in
Hypercalcemia
Hypercalciuria
Nephrolithiasis
Confirmation of sarcoidosis
Proof of granulomatous involvement in at least 2 separate organs
Histologic confirmation is not necessarily required in the second organ
Epithelioid cell of the sarcoidal granuloma secretes _____
Serum angiotensin-converting enzyme
Serum angiotensin-converting enzyme levels reflect _____ and may be useful for monitoring _____
Total granuloma burden
Course of sarcoidosis
_____ on chest radiograph almost always represent sarcoidosis
Asymptomatic hilar adenopathy
Bilateral lacrimal and parotid gland gallium-67 uptake
Panda sign
Bilateral hilar and right paratracheal gallium-67 uptake
Lambda sign
Pathology of sarcoidosis
Naked granulomas
Development of _____ causes almost all significant impairment from sarcoidosis
Fibrosis
Patients with cutaneous lesions are more likely to have _____ than patients without skin involvement
Chronic systemic sarcoidosis
Most reliable immediate initial therapy for sarcoidosis
Systemic corticosteroids
Useful for sarcoidosis affecting the joints and skin, and hypercalcemia
Antimalarials
Particularly useful for the treatment of lupus pernio
Infliximab
Reserved for life-threatening disease because of carcinogenicity
Cyclophosphamide
