PMC6262779_01
Clinical presentation over 14 years of follow-up for presumed sarcoidosis. Erythematous slightly squamous plaques on right arm and back in 2001 (A and A'). Centrifugal extension with central atrophic areas in 2011 (B and B') and 2015 (C and C') despite successive treatments.
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A woman with no medical history was seen in our department for the first time in 2001 at the age of 62 with erythematous slightly squamous plaques on the right arm and back (Fig 1, A). The lesions failed to respond and were slowly extending centrifugally with atrophic zones, without any systemic involvement (Fig 1, B and C).
Clinical presentation at time of diagnosis of M bovis infection. Clinical exacerbation after 6 months of MM treatment (A and A'). Skin biopsy: inflammatory dermis infiltrate with no caseating granulomas. (B, Hematoxylin-eosin stain; original magnifications: B, x25; B', x100.). Complete regression after 8 months of antibiotherapy (C and C').
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Six months later, the plaques suddenly worsened and became erosive and extensive (Fig 2, A). A new skin biopsy of ulcerative lesions showed an inflammatory infiltrate in the dermis with an ill-defined noncaseating granuloma (Fig 2, B). The ulceration rapidly healed and the lesions gradually resolved and cleared, with only hypertrophic scars remaining at the end of treatment (Fig 2, C) without recurrence after 18 months of follow-up.