LINEAR SARCOIDOSIS (COUP DE SABRE)

Diagnosis: LINEAR SARCOIDOSIS (COUP DE SABRE)

Case submitted by Dr.Azeem Alam Khan to the dermRounds community.

Clinical Presentation

Clinical photograph(s) submitted for peer review and discussion.

Clinical History

Submitted by Dr.Azeem Alam Khan. Originally posted May 13, 2009.

Treatment

See case discussion.

Differential Diagnosis

• Granuloma annulare • Foreign body granuloma • Lupus vulgaris (cutaneous TB) • Lymphoma • Rosacea • Leprosy • Tinea faciei

Key Learnings

• Non-caseating granulomatous disease of unknown etiology • Cutaneous involvement in ~25-35% of patients • Skin lesions: papules, nodules, plaques — classically red-brown to violaceous • Lupus pernio: violaceous plaques on nose, cheeks, ears — indicates chronic, severe disease • Erythema nodosum is the most common nonspecific cutaneous finding • Löfgren syndrome: bilateral hilar lymphadenopathy + erythema nodosum + polyarthralgias + fever (good prognosis) • Diascopy reveals "apple jelly" color — typical of granulomatous inflammation • Scar sarcoidosis: granulomas develop within old scars

Tags: linear, sarcoidosis, coup, sabre, dr.azeem alam khan