Sarcoid Granulomas Over Scars: Beyond Sarcoidosis

• Autor(a) principal: Morgado, Francisca
• Data de Publicação: 2022
• Outros Autores: Batista, Mariana, Cardoso, José Carlos, Gonçalo, Margarida
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13451
• topic: Cicatrix; Contact Dermatitis; Granuloma; Palladium; Sarcoidosis; Cicatriz; Dermatite de Contacto; Granuloma; Paládio; Sarcoidose

Sarcoid granulomas can be found in a wide range of diseases and differentiating sarcoidosis from a sarcoid-like reaction may be a challenge. We present a woman with erythematoviolaceous papulonodular lesions located on the ears where piercings were placed. A skin biopsy showing an infiltrate of sarcoid and focal tuberculoid granulomas did not exclude sarcoidosis. There was a slight increase in the level of angiotensin-converting enzyme. Systemic involvement due to sarcoidosis was excluded. Epicutaneous tests performed revealed a strong positive reaction to palladium and nickel, supporting the diagnosis of granulomatous contact dermatitis. There are only a few reports of granulomatous contact dermatitis to palladium with piercings as the source of sensitization. The formation of sarcoid granulomas can represent either a sarcoid-like reaction or a form of cutaneous sarcoidosis, and patch tests are essential in order to establish the diagnosis.