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BMJ Case Reports 2015; doi:10.1136/bcr-2015-209337
  • CASE REPORT

Subcutaneous sarcoidosis in a rhinoplasty scar

  1. Basile Nicolas Landis
  1. Department of Otorhinolaryngology, University of Geneva Hospital, Geneva, Switzerland
  1. Correspondence to Dr Nicolas Dulguerov, nicolas.dulguerov{at}hcuge.ch
  • Accepted 26 February 2015
  • Published 27 March 2015

Summary

The presence of a subcutaneous hard bony-like lump at the lateral nasal wall after a septorhinoplasty procedure is an unfavourable result. The reported patient developed this complication 2 years after a revision surgery, in which percutaneous osteotomies were performed. An excision biopsy of the lump took place and the histopathological analysis revealed a granulomatous gigantocellular inflammation with absence of birefringent particles on polarised lamp and negative mycobacteria culture. After additional investigations, the final diagnosis was consistent with grade 2 pulmonary sarcoidosis associated with subcutaneous sarcoidosis. No treatment was initiated. The facial symptoms resolved without any additional treatment and the pulmonary function tests have not deteriorated after 1 year of follow-up. The polymorphism of cutaneous lesions in sarcoidosis, the absence of systemic symptoms and the unrecognised entity of subcutaneous sarcoidosis in a scar illustrate the diagnostic challenge with this patient.

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