Sunday, October 28, 2007

Cutaneous Sarcoidosis Mimicing Nasal Skin Tumor: Lupus Pernio

Furkan Erol Karabekmez, MD, Ahmet Duymaz, MD, Mehtap Karamese, MD, Mustafa Keskin, MD, Zekeriya Tosun, MD, and Nedim Savaci, MD.

Lupus pernio (LP) is the most characteristic lesion of sarcoidosis that occurs most commonly on the nose, perioral region, ears, fingers, and eyelids. Lesions are violaceous, indurated plaques that resemble those seen in persons with an acute cold injury and rarely appear as the initial symptom of systemic sarcoidosis. 65 years old women admitted to hospital for unhealed wound in her nose. Patients had two years history of wound in her nose. Ulserated, irregular , indurated plaque which was 2x3 cm size found on her examination. Biopsy was taken, and pathological examination revealed similar findings with granulomatous disease. Therefore, computerized tomography of the lung was revealed pleural thickness, pleuroparanchimal fibrotic changes, and perivascular lenfadenopathies and than patient has been consultated to internal medicine department. Oral corticosteroid therapy was begun to patient who was diagnosed as the sarcoidosis and lasted for three months. The lesion was excised and defect was reconstructed with full thickness skingraft because there was no regression of lesion. After six month follow we obtained an acceptable aesthetic outcome obtained. LP on the nose which particularly in patients do not already have a sarcoidosis diagnose easily misdiagnosed as malign skin tumor. In this case report a patient with a nasal LP mimicking skin tumor was presented and the role of a plastic surgeon was discussed in the treatment of LP.

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