35 - Sarcoidosis

Question 1

Disease onset of sarcoidosis is most common in the _____ decade and is slightly higher in ______

Answer 1

Third

Women

Question 2

Sarcoidosis has a higher incidence with

Answer 2

Greater distance from the equator

Question 3

Highest prevalence of sarcoidisis is in

Answer 3

African American women

Question 4

With the advent of penicillin, _____ has replaced syphilis as the great mimicker for dermatologists

Answer 4

Sarcoidosis

Question 5

Sarcoidal lesions are divided into

Answer 5

Specific - have granulomatous inflammation

Nonspecific - reactive and do not exhibit sarcoidal granulomas

Question 6

Most common presentation of sarcoidosis

Answer 6

Papular form

Question 7

“Apple jelly”: _____ coloration

Answer 7

Yellow-brown

Question 9

Apple jelly appearance on dermoscopy differentials

Answer 9

Sarcoidosis
Lupus vulgaris
Granuloma annulare

Question 10

Dermoscopic findings significantly associated with cutaneous sarcoidosis

Answer 10

Pink homogenous background
Translucent orange areas
Fine white scaling
Scar-like depigmentation

Question 11

Papular lesions most commonly occur on

Answer 11

Face and neck, with predilection for periorbital skin

Question 12

Relatively symmetric, violaceous, indurated plaques and nodules occurring on the nose, earlobes, cheeks, and digits

Answer 12

Lupus pernio

Question 13

Lupus pernio is associated with higher incidence of

Answer 13

Systemic involvement and upper respiratory tract disease

Question 14

Present as persistent subcutaneous nodules preferentially on the extremities

Answer 14

Darier-Roussy sarcoid

Question 15

Sarcoidal infiltration of the gingiva causes

Answer 15

Strawberry gums

Question 16

Mucosal membrane sarcoidosis involving the gingiva mimicks

Answer 16

Wegener granulomatosis

Question 17

Bilateral enlargement of the lacrimal, parotid, sublingual, and submandibular glands

Answer 17

Mikulicz syndrome

Question 18

Main nonspecific cutaneous manifestation of sarcoidosis

Answer 18

Erythema nodosum

Question 19

Erythema nodosum with bilateral hilar adenopathy, arthralgia, and fever

Answer 19

Lofgren syndrome

Question 20

Most common organ involved with sarcoidosis

Answer 20

Lung

Question 21

Most commonly affected portion of the eye in sarcoidosis

Answer 21

Uvea

Question 22

Fever, parotid gland enlargement, facial palsy, and anterior uveitis

Answer 22

Heerfordt syndrome

Question 23

Neurosarcoidosis has a predilection for

Answer 23

Base of the brain

Question 24

Most common manifestation of neurosarcoidosis

Answer 24

Cranial neuropathies

Question 25

Most frequently involved nerve in neurosarcoidosis

Answer 25

Facial nerve

Question 26

Pink and violaceous papules and plaques with prominent telangiectasia that usually occur on the face; considered a variant of lupus pernio

Answer 26

Angiolupoid lesions

Question 27

Activated sarcoidal macrophages have increased _____ activity which converts inactive to the active form of vitamin D

Answer 27

1 alpha-hydroxylase

Question 28

Renal sarcoidosis results in

Answer 28

Hypercalcemia
Hypercalciuria
Nephrolithiasis

Question 29

Confirmation of sarcoidosis

Answer 29

Proof of granulomatous involvement in at least 2 separate organs

Histologic confirmation is not necessarily required in the second organ

Question 30

Epithelioid cell of the sarcoidal granuloma secretes _____

Answer 30

Serum angiotensin-converting enzyme

Question 31

Serum angiotensin-converting enzyme levels reflect _____ and may be useful for monitoring _____

Answer 31

Total granuloma burden

Course of sarcoidosis

Question 32

_____ on chest radiograph almost always represent sarcoidosis

Answer 32

Asymptomatic hilar adenopathy

Question 33

Bilateral lacrimal and parotid gland gallium-67 uptake

Answer 33

Panda sign

Question 34

Bilateral hilar and right paratracheal gallium-67 uptake

Answer 34

Lambda sign

Question 35

Pathology of sarcoidosis

Answer 35

Naked granulomas

Question 36

Development of _____ causes almost all significant impairment from sarcoidosis

Answer 36

Fibrosis

Question 37

Patients with cutaneous lesions are more likely to have _____ than patients without skin involvement

Answer 37

Chronic systemic sarcoidosis

Question 38

Most reliable immediate initial therapy for sarcoidosis

Answer 38

Systemic corticosteroids

Question 39

Useful for sarcoidosis affecting the joints and skin, and hypercalcemia

Answer 39

Antimalarials

Question 40

Particularly useful for the treatment of lupus pernio

Answer 40

Infliximab

Question 41

Reserved for life-threatening disease because of carcinogenicity

Answer 41

Cyclophosphamide