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Title: Sarcoidosis presenting as papulonecrotic tuberculid-like lesions: Report of a case
Authors: Phanorn Chalermdamrichai
Siripen Puavilai
Suthep Jerasutus
Viboon Boonsarngsuk
Sumalee Kiattboonsri
Thitiporn Suwatanapongched
Mahidol University
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Keywords: Medicine
Issue Date: 1-Jul-2004
Citation: Journal of the Medical Association of Thailand. Vol.87, No.7 (2004), 839-844
Abstract: A 50-year-old Thai woman presented with papulonecrotic tuberculid-like eruptions on her back and inframammary area with fever, nonproductive cough and weight loss. Chest radiograph showed diffuse bilateral reticulonodular opacities in both lungs with bilateral hilar lymph node enlargement. High resolution computed tomography (HRCT) of the lungs showed peribronchovascular interstitial thickening with multiple lymph nodes enlargement. Sputum for AFB was negative. Monotest (PPD) was negative. Skin biopsy revealed multiple naked granuloma compatible with sarcoidosis. She was treated with isoniazid, 300mg/d, rifamipicin, 600 mg/d, ethambutal, 800, mg/d and pyrazinamide, 1000 mg/d for 2 months without improvement of skin and lung lesions. Prednisolone 45 mg/d was then administered adjunctive with isoniazid and rifampicin. After two weeks of treatment with prednisolone, the cutaneous and pulmonary lesions markedly improved. Prednisolone was tapered in 6 months. Skin lesions, fever, dry cough disappeared and chest radiograph, HRCT of the chest were markedly improved.
ISSN: 01252208
Appears in Collections:Scopus 2001-2005

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