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Cutaneous sarcoidosis misdiagnosed as cutaneous tuberculosis
( Jae Min Sung ) , ( Sue Kyung Kim )
프로그램북 68권 1호 306-307(2pages)
UCI I410-ECN-0102-2017-510-000081325
이 자료는 4페이지 이하의 자료입니다.

Herein, we report a case of cutaneous sarcoidosis that is misdiagnosed as tuberculosis at first. A 52-year-old woman presented with a 3-month history of erythematous nodules and swelling on both upper eyelids. She had surgical history of blepharoplasty about 10 years ago. Skin biopsy from upper eyelid revealed multiple non-caseating granulomas in dermis. Mycobacterium tuberculosis (M.tuberculosis) Polymerase Chain Reaction (PCR) with the tissue was done and the result was positive. Also, serum interferon gamma release assay (IGRAs) result was positive and angiotensin converting enzyme level was slightly elevated. Based on the positive result of M.tuberculosis PCR and IGRAs, the diagnosis of tuberculosis was made. Despite 2-month treatment of anti-tuberculosis medication, skin lesions were getting worse. Therefore, additional skin biopsy was done at right upper eyelid. AFB stain, AFB culture, M.tuberculosis PCR in the tissue were all negative. Chest CT scan was also done and the result suggested pulmonary sarcoidosis. The amended diagnosis was sarcoidosis. 4 months after systemic corticosteroid treatment, skin lesion has almost cleared. Considering that there have been many reports of positive result of M.tuberculosis PCR in sarcoidosis tissue and IGRAs including this case, who makes the diagnosis of tuberculosis based on the result of PCR and IGRAs needs to be careful.

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