Skin Sarcoidosis

A comprehensive overview of sarcoidosis covering subjects like symptoms, diagnostics, research, causes and pictures
Skin Sarcoidosis

Skin sarcoidosis

     Sarcoidosis is a systemic disease (affects several groups of organs) that has unknown causes.

     For a long time the disease has been known as Besnier-Boeck-Schauman.

     It affects mostly young or middle-aged persons and the most frequent forms are pulmonary, eye and skin sarcoidosis. It can also affect liver, spleen, lymph nodes, salivary glands, heart, nervous system, muscles, bones and other organs.

     Although it affects people of all ages and all races across the world, there is a noticeable heterogeneity in epidemiological prevalence, presentation and severity of skin sarcoidosis among various ethnic groups and between different geographical regions professional.

     The prevalence of skin sarcoidosis ranges from less than 1 in 10,000 in Central and South America, Africa and Portugal and 64 to 10,000 in Scandinavia and the U.S. African-America population.

     In Eastern Europe is estimated that prevalence of skin sarcoidosis would be around 4 per 10,000. Elderly and children are rarely diagnosed with skin sarcoidasis, the most affected age is between 20 and 40 years, with a slight predominance for women.

     The causes for skin sarcoidosis are so far unknown. Heterogeneity of sarcoidosis epidemiology led to the development of several theories: some related to environmental factors, other genetic susceptibility of the patient.

     Involvement of environmental factors in skin sarcoidosis is mainly reasoned by seasonal variation (the onset is more often in late winter and spring) and the concentration of cases in different areas (geographical, professional and family).

     A number of different factors are involved:

  • environmental: pine pollen, clay soil, water sources, certain plants or pollens
  • work environment: inorganic agents

     The most attractive hypothesis relating to the etiology of skin sarcoidosis is:

  • Infectious agents: bacteria, viruses, fungi (mushrooms).

     Several observations suggest the intervention of genetic factors. The families of a patient with skin sarcoidosis have a degree several times higher than the general population to catch their self this disease.

     Skin sarcoidosis is accompanied by the appearance of areas of inflammation, called granulomas, under the skin. It is suspected that inflammation in skin sarcoidosis is actually the human body's response to one of the abusers mentioned above.

     Inflammatory stages of skin sarcoidosis are:

  • the aggressor enter the body (ex inhaled) and it is recognized by the macrophages (cells that have a role in defending the body)
  • it activates macrophages and other cells that possess defense capability - lymphocytes
  • the agglomeration of these cells leads to the formation of granulomas
  • repair mechanisms occur, for the removal of inflammatory reactions
  • depending on the persistence of repair mechanisms, the disease can develop into perpetuating or to cure

     Granulomas localization is possible in almost any organ, most commonly the lungs (and can be distributed around the airways) and skin.

     It is important to remember that skin sarcoidosis is not contagious.

     Patient with sarcoidosis can present clinically as follows:

  1. Asymptomatic - he does not complain about anything, the discovery is done randomly (often after a chest X-ray)
  2. With general non-specific manifestations - fever, muscle aches, fatigue, weight loss
  3. With specific events related to damage of organs:
    • lungs: chest pain, coughing, choking, whistling
    • ganglia: increase of internal nodes (near the lung) and external (usually the neck or armpits)
    • Skin: appearance of spots or nodules that are red or purple; the painful red-purple nodules that appear on the leg called erythema nodosum. In skin sarcoidosis, purple granuloms may appear on the face, fingers and knees (called lupus pernio). Some lesions may be disfiguring.
    • Joints: pain and swelling in the joints, especially of punches, elbows, ankles and knees.
    • Eye: tearing, redness, blurred vision. Ocular sarcoidosis can develop into cataracts, glaucoma or retinal detachment and blindness.
    • salivary glands: they can increase, leading to the appearance of swelling behind the ears, swelling that can be confused with those caused by mumps, uniting patients complain of dry mouth.
    • Heart: is very rarely affected, palpitations may occur.
    • nervous system: can affect any area of the nervous system, but with predilection for the skull, appear headache, dizziness, decreased sensation in hands