Sarcoidosis is a progressive systemic granulomatous disease involving possibly any organ or tissue in our body.
The very name sarcoidosis is derived from the fact that it causes ‘flesh-like’ lesions. Sarcoidosis was first identified over 100 years ago by two dermatologists working independently, Dr. Jonathan Hutchinson in England and Dr. Caesar Boeck in Norway. Sarcoidosis was originally called Hutchinson’s disease or Boeck’s disease. Dr. Boeck went on to fashion today’s name for the disease from the Greek words “sark” and “oid,” meaning flesh-like. The term describes the skin eruptions that are frequently caused by the illness.
The skin is affected in around 20 % of sarcoidosis patients. Skin sarcoidosis is usually marked by small, raised patches on the face. Occasionally the patches are purplish or red in color and larger. Patches can also appear on limbs, face, and buttocks. Other symptoms include Erythema nodosum, mostly on the legs and often accompanied by arthritis in the ankles, elbows, wrists, and hands. Erythema* nodosum usually goes away, but other skin problems can persist.
*Erythema: A name applied to redness of the skin produced by congestion of the capillaries, which may result from a variety of causes, the etiology or a specific type of lesion often being indicated by a modifying term. [EU]
Skin manifestations of sarcoidosis can be either specific or nonspecific (the latter being when no evidence of granuloma is found in tissue biopsy)but most are granulomatous and occur more commonly in African American patients.
With this kind of grim expectations, one should be extremely careful and always on the watch for evidence of skin involvement if diagnosed with sarcoidosis. Using a special protocol, the author of this article induced remission of her own sarcoidosis in 3 and a half months. The system used is named the Aden Protocol and is the only system in existence that offers this kind of hope. Click the button bellow to learn about it.
The lesions of sarcoidosis are lupus pernio, plaques, and maculopapular eruptions. Lupus pernio, the most characteristic of all sarcoid skin lesions, is a chronic, violaceous, indurated skin lesion. Skin plaques are purplish, elevated, indurated patches usually located on the limbs, face, back, and buttocks. Papular eruptions are the most common skin manifestation of sarcoidosis in African Americans. Other skin changes include subcutaneous nodules; scarring from atrophy, trauma, surgery, or venipuncture; and erythema nodosum. The clinical manifestations of sarcoidosis depend on age, race, duration of the illness, site and extent of tissue involvement, and activity of the granulomatous process.
Laboratory findings include hypercalcemia and increased serum angiotensin-converting enzyme in about 60 percent of patients. Immunologic features include depression of cutaneous delayed-type hypersensitivity reactions, lymphopenia - decreased number of lymphocytes (white blood cells) in the blood, and expansion of the T lymphocytes in bronchoalveolar lavage fluid. Diagnosis is based on a compatible clinical or radiographic picture, histologic evidence of noncaseating granulomas, and negative special stains and cultures for other entities. Therapeutic options in the modern medicine include glucocorticoids, antimalarials, immunosuppressive drugs, and cosmetic surgery. 6 figures and 14 references. But in the Aden protocol, things are approached a little bit different. Underlying causes are dealt with after relevant relationships are restored between sarcoidosis and it’s triggers.
It is not rare that sarcoidosis of the skin is confused with other disorders (e.g. psoriasis).
According to D.G. James, M.D., purple lupus or lupus pernio was reported by Ernest Besnier, MD, as early as 1889. Besnier described it as a chronic, persistent violaceous skin lesion. Most commonly found on the nose, cheeks,lips, ears or fingers, it can be a very disfiguring form of the disease. It is not limited to the upper areas of the body but can be found in extreme cases in other regions including the buttocks and the thighs. It is twice as common in females and more often among Afro-ethnic populations throughout the world. When present, it is often associated with other systemic forms of Sarcoidosis including the upper respiratory track, bone cysts, lacrimal gland involvement and renal sarcoidosis. It develops slowly and progressively over the years.
Papule lesions (pimples) are classified as specific. Waxy or translucent, rounded, brownish or reddish brown clusters of lesions with granuloma formation on microscopic examination, are sarcoid lesions. Thick papules are called nodules and when areas coalesce (fuse, run, grow together) they are known as plaque, a medical term for patch on the skin.
When areas are large enough they can break down the skin causing ulcers to form. Usually chronic sarcoidosis skin lesions do not cause pain or itch.
So, what can you expect when you come to your local doctor that deals with the conditions of the skin?
A corticosteroid is usually the primary drug prescribed when there is other organ involvement. Thick lesions may best respond to injection at the lesion site, when delivery of a concentrated dose with minimal systemic dosingis desired.
Such is the case when thicker lesions do not respond to steroid based creams and/or systemic therapy. Topical corticosteroid creams are most effective on thin skin lesions. Sometimes the skin can be encouraged to absorb more ointment medication by covering the lesions with a plastic wrap. These are al means of addressing the issue of the skin lesion described in the modern medicine. But none of them treats the actual underlying cause.
The core of the Aden protocol that lifted so much dust back in 2006 is the fact that it establishes connections and relationships that were overlooked by the medical research in the past. Click the button bellow to learn how today sarcoidosis finally is not such big of a deal. This is the only protocol in existence that was proven to induce sarcoidosis remission.