The answer to yesterday’s mystery is … Sarcoidosis! This was a hard one for you all – k, colleen (with a little c), ColorMaven, ED Doc, and Angelita were the only people to nail down the diagnosis.
Sarcoidosis is a unique disease — doctors have no idea what causes it! The hypotheses range from an environmental exposure, to an underlying genetic predisposition, to an undiscovered infectious agent. Pathologists have discovered that in sarcoidosis, collections of white blood cells (immune system cells) called granulomas form in various tissues of the body. The most commonly affected organ is the lungs, followed by the skin, joints, and the eye. Patients can develop a cough (like our patient), and a wide variety of rashes (our patient developed a rash on the nose called lupus pernio). Patients can also experience nonspecific symptoms like fatigue, fever, muscle/joint aches, and weight loss. The lymph nodes in the center of the chest become enlarged in the vast majority of cases, which was seen on our patient’s chest x-ray.
Sarcoidosis is treated with steroids to decrease inflammation and activation of the immune system cells. Steroid cream can help with skin lesions (as seen in the picture), and inhaled steroids can decrease lung symptoms. Fortunately, sarcoidosis has a good prognosis, and is rarely ever fatal or progressive. Thanks again to the reader who suggested this disease. If you have a suggestion, email me – mdtobeblog (at) gmail (dot) com.