Recurrent sarcoidosis on a scar associated with vitiligo

Abstract

We report a case of systemic sarcoidosis, diagnosed 13 years ago by transbronchial biopsy. Our patient had a spontaneous resolution of hilar and mediastinal lymphadenopathy 6 months after diagnosis. She presented with a skin rash on her thyroidectomy scar after a period of 4 years of complete remission. The patient complained that her thyroidectomy incision scar rose up, reddened and hardened. Biopsy of the skin lesion revealed non-caseating epithelioid granulomas with histiocytes and multinucleated giant cells. She was successfully treated with oral prednisone. Scar sarcoidosis recurred twice in a 7-year follow-up period without accompanying systemic sarcoidosis. Vitiligo appeared with the last relapse of scar sarcoidosis. The case we present is of interest due to the recurrent attacks of scar sarcoidosis in a patient during the remission period of systemic sarcoidosis. Another aspect of this case is the association of the disease with vitiligo without any sign of an autoimmune disease.