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Case report
Systemic sarcoidosis revealed by venepunctures: a very rare but rewarding cutaneous manifestation
  1. Martin Killian1,2,
  2. Cyril Habougit3,
  3. Eric Monard4 and
  4. Baptiste Gramont1
  1. 1Department of Internal Medicine, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, Loire, France
  2. 2GIMAP, Université Jean Monnet Saint-Etienne, Saint-Etienne, Loire, France
  3. 3Laboratory of Pathology, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, Loire, France
  4. 4Department of Internal Medicine, Centre Hospitalier Chalon sur Saone, Chalon-sur-Saone, France
  1. Correspondence to Dr Martin Killian; martin.killian{at}chu-st-etienne.fr

Abstract

A 67-year-old man was referred to our department for the onset of cutaneous lesions following venepunctures. His recent medical history included brief flu-like syndrome, persistent cough, dyspnoea, dry mouth, blurred vision and weight loss. The extensive clinical, biological and radiological check-up showed signs consistent with systemic sarcoidosis: right uveitis, hypercalcemia, renal failure, inflammatory syndrome, elevated levels of ACE, alveolitis with elevated CD4+/CD8+ T cell ratio, hilar and mediastinal lymphadenopathy, bilateral pulmonary infiltrates, mild bronchial obstruction and lowered diffusing capacity of the lungs for carbon monoxide. Multiple biopsy samples (bronchus, accessory salivary glands and one of the skin lesions) eventually confirmed the diagnosis. Corticosteroids resulted in skin lesions resolution in a few days and overall clinical, biological and lung function improvement. The infiltration of scars by granulomatous tissue is well recognised in sarcoidosis but its onset in venepuncture sites is a very rare but easily recognisable condition, which can be helpful for quick diagnosis purpose.

  • dermatology
  • immunology
  • anterior chamber
  • pathology
  • interstitial lung disease
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Footnotes

  • Contributors MK wrote the manuscript. CH managed the pathology work. EM managed the case. CH, EM and BG critically reviewed the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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