The sarcoidal granuloma: A unifying hypothesis for an enigmatic response.

Clin Dermatol

Department of Dermatology, University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216; Department of Pathology, University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216; Department of Dermatology, University of Rochester School of Medicine and Dentistry, 601 Elm

Published: May 2015


Category Ranking

98%

Total Visits

921

Avg Visit Duration

2 minutes

Citations

20

Article Abstract

Although the cause of sarcoidosis is unknown, there is growing support for the concept that sarcoidal granulomas result from a hypersensitivity reaction producing a nonspecific response to an extrinsic or intrinsic (autoimmune) antigen in genetically susceptible individuals. The immune milieu associated with these antigens, localized in a specific cutaneous area, produces a variant of Ruocco's "immunocompromised district." This may explain the predilection for sarcoidal granulomas in association with foreign bodies, tattoos, herpes zoster-affected dermatomes, and scars. Similar antigenic stimulation produces sarcoidal granulomas surrounding internal tumors. Finally, systemic sarcoidosis, as manifested by hilar adenopathy, may reflect the lymphatic spread of foreign antigens.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clindermatol.2014.04.013DOI Listing

Publication Analysis

Top Keywords

sarcoidal granulomas
12
sarcoidal
4
sarcoidal granuloma
4
granuloma unifying
4
unifying hypothesis
4
hypothesis enigmatic
4
enigmatic response
4
response sarcoidosis
4
sarcoidosis unknown
4
unknown growing
4

Similar Publications

Myopathology and Immune Profile of Granulomatous Myositis in Sarcoid Myopathy.

Neuropathol Appl Neurobiol

October 2025

Division of Rheumatology and Systemic Inflammatory Diseases, III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Aims: Sarcoid myopathy (SaM) is characterised by granulomatous myositis (GM) and can overlap with inclusion body myositis (IBM), a late-onset chronic idiopathic inflammatory myopathy with a still enigmatic pathogenesis. As GM can occur in different clinical contexts, we aimed to examine the histomorphologic features and gene expression profiles in cases of definite SaM that may inform diagnostic and therapeutic considerations.

Methods: We performed a multidimensional characterisation of muscle biopsy specimens from patients with 'pure SaM' (n=17), SaM with concomitant IBM (SaM-IBM) (n=2), including histopathologic and ultrastructural analysis in addition to quantitative real-time polymerase chain reaction.

View Article and Find Full Text PDF

Case Report: Sarcoidosis or tuberculosis? A continuous challenge.

Front Med (Lausanne)

August 2025

Department of Pulmonology, Institute of Pneumology, Bucharest, Romania.

Sarcoidosis is a multisystem granulomatous disorder of unknown etiology, characterized by the formation of non-caseating granulomas in affected tissues and organs. In over half of the cases, the disease undergoes spontaneous remission. In contrast, tuberculosis (TB) is an infectious disease caused by , which, if left untreated, can be fatal.

View Article and Find Full Text PDF

[Spontaneous remissive pulmonary sarcoidosis in a patient with a history of surgical resection of lung adenocarcinoma: a case report].

Zhonghua Jie He He Hu Xi Za Zhi

September 2025

Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

Pulmonary patches with mediastinal lymphadenopathy could be showed in both lung cancer and sarcoidosis. There are certain similarities in their imaging manifestations, and histopathological examination is necessary for diagnosis. This article reports a case of a 62-year-old female patient who had a history of early-stage lung adenocarcinoma and underwent surgical treatment.

View Article and Find Full Text PDF

Right Ventricle-Dominant Cardiac Sarcoidosis Diagnosed Using a Multimodal Approach.

JACC Case Rep

September 2025

Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.

Background: Cardiac sarcoidosis (CS) usually affects the left ventricle and presents with nonspecific features like conduction abnormalities and ventricular arrhythmias. However, right ventricle (RV)-dominant involvement has been increasingly reported, making diagnosis difficult.

Case Summary: A 55-year-old man presented with palpitations.

View Article and Find Full Text PDF

Sarcoidosis often manifests with pulmonary involvement, making isolated extrapulmonary presentations rare and diagnostically challenging. We present the case of a 43-year-old woman who presented with prolonged fever, deep lymphadenopathy, massive splenomegaly, hepatomegaly, and severe hypercalcemia, mimicking malignancy. The diagnosis of sarcoidosis was established after the failure of anti-tubercular therapy, exclusion of differential diagnosis, and the subsequent development of cutaneous sarcoids.

View Article and Find Full Text PDF