Perineural granulomas in cutaneous sarcoidosis may be associated with sarcoidosis small-fiber neuropathy

Journal of Cutaneous Pathology
William R MundayAnjela Galan

Abstract

Perineural granulomas in cutaneous sarcoidosis have been rarely reported and their clinical significance has yet to be evaluated. Recently, a 27-year-old male presented with multiple pink papules on the flank and lower back, accompanied by a painful, burning sensation. Biopsies revealed well-defined granulomas, consistent with sarcoidosis, in the dermis and involving small cutaneous nerves. We hypothesized that perineural granulomas may be an under-recognized feature of cutaneous sarcoidosis and may be responsible for sensory disturbances. We reviewed cases from 29 consecutive patients with cutaneous sarcoidosis. Perineural granulomas were identified in 18/29 (62%) patients and in 22/40 (55%) biopsies. Perineural granulomas were identified in 7/9 biopsies from the proximal upper extremity, 1/3 from the distal upper extremity, 7/12 from the head and the neck, including 4/4 from the nose, 5/9 from the back, 1/2 from the flank and 1/1 from the proximal lower extremity and 0/4 from the distal lower extremity. The anatomical distribution is similar to sarcoidosis small-fiber neuropathy (SSFN), in which sarcoidosis patients without evident skin lesions experience sensory disturbances of unknown etiology involving the face, the proxim...Continue Reading

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Citations

Feb 14, 2016·Muscle & Nerve·Amanda Cy Chan, Einar P Wilder-Smith
Oct 27, 2017·Journal of Cutaneous Pathology·Fabiane Leonel UtinoMaria Letícia Cintra
Feb 6, 2020·Journal of Cutaneous Pathology·Rashek KaziArivarasan Karunamurthy
May 4, 2020·Journal of Cutaneous Pathology·Michele DonatiPietro Donati
Dec 12, 2020·Journal of Cutaneous Pathology·Carla StephanOssama Abbas
May 11, 2016·Clinics and Practice·Adriana Handra-Luca
Aug 11, 2021·Muscle & Nerve·Franco GemignaniGiovanni Pavesi

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