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KMID : 0363220180560030192
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Korean Journal of Dermatology
2018 Volume.56 No. 3 p.192 ~ p.196
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Cutaneous Sarcoidosis on Bilateral Upper Eyelids Misdiagnosed as Cutaneous Tuberculosis
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Sung Jae-Min
Kim Sue-Kyung
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Abstract
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A 52-year-old woman presented with erythematous nodules and swelling on both upper eyelids. She had a surgical history of blepharoplasty about 10 years previously. Skin biopsy revealed non-caseating granulomas in the dermis. Mycobacterium tuberculosis (MTB) polymerase chain reaction (PCR) testing of the tissue sample was positive. In addition, the serum interferon gamma release assay (IGRAs) result was positive. Based on the positive result of MTB PCR and IGRAs, a diagnosis of tuberculosis was made. Despite a 2-month treatment with anti-tuberculosis medication, the skin lesions worsened. An additional skin biopsy was taken and AFB stain, AFB culture, and MTB PCR of the tissue were all negative. Four months after systemic corticosteroid treatment, the skin lesion had almost cleared. Considering that there have been many reports of positive results of MTB PCR in sarcoidosis tissue and IGRAs, a diagnosis of tuberculosis based on the results of PCR and IGRAs needs to be interpreted with caution. Also, evaluation of other organ involvement including the lungs can be helpful in making a correct diagnosis.
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KEYWORD
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Sarcoidosis, Tuberculosis
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