PMC8458104_01
Photography of the skin lesions visible as bilateral multiple erythematous and indurated plaques in the malleolar and pretibial areas.
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The physical examination revealed bilateral multiple erythematous and indurated warm plaques with palpable subcutaneous nodules in the malleolar and pretibial areas (Fig. 1) in addition to mild inspiratory crepitations over the basal lung areas.
Chest X-ray - posteroanterior view. Native chest X-ray patient chest revealing bilateral enlargement of hilar lymph nodes.
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C-reactive protein (147 mg/L), interleukin-6 (160.5 pg/mL), D-dimer (2.15 mg/L) and fibrinogen (6.2 g/L) in addition to leukocytosis (10,870 cells/mL) with absolute neutrophilia (8770 cells/mL). Chest X-ray revealed bilateral hilar enlargement and inflammatory infiltrations in the lower right lung field (Fig. 2).
Tomogram - transversal plane. Native tomogram in the transversal plane of the patient chest revealing bilateral enlargement of hilar lymph nodes.
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To elucidate the X-ray findings of hilar enlargement, computed tomography was performed, which revealed bilateral hilar and mediastinal lymphadenopathy with largest lymph nodes up to 16 mm in diameter, consistent with stage I pulmonary sarcoidosis (Fig. 3).