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SARCOIDOSIS OG HUDEN

Sarcoidosis of the skin occurs in 20 to 35% of all sarcoidosis patients. Sometimes a skin condition may be the only complaint. There are several types of skin disorders that can occur with sarcoidosis including erythema nodosum, lupus pernio and brownish-red lumps and bumps (lesions).

Oplysningerne på denne side er blevet udarbejdet ved hjælp af sarcoidosis specialist Dr. S. Walsh, Konsulent Dermatolog, Kings College Hospital, London.

Erythema Nodosum

Erythema Nodosum er den mest almindelige sarcoidose-relaterede hudtilstand. Det forekommer ofte i den akutte form af sygdommen.

Symptomer:

  • pludselige røde, smertefulde klumper, normalt på underben eller arme
  • ofte ledsaget af feber, træthed og ledsmerter

Behandling:

  • ofte forbedrer spontant efter 3 til 6 uger, kan enkle smertestillende midler som paracetamol og ibuprofen hjælpe med symptomerne
  • lilla-blå farve kan forblive synlig i nogle få uger
  • inden for 6 måneder helbredes 80% sager fuldstændigt uden ardannelse

De fleste patienter med erythema nodosum har andre tilstande end sarcoidose (fx bakterier eller svampeinfektioner). Derudover kan visse lægemidler forårsage det. Denne hudtilstand indikerer ikke altid automatisk sarkoidose.

Download indlægssedlen:

Sarcoidose og huden:

Lupus Pernio

Lupus Pernio kan også forekomme ved sarkoidose.

Symptomer:

  • blå / rød flad misfarvning, eller hævelse, normalt over broen af næse og kinder
  • smertefuld hud
  • overfladiske læsioner
  • forekommer i ansigt, ører, fingre eller tæer

Behandling:

Lupus pernio is a chronic condition; it rarely disappears spontaneously and can cause permanent damage to the skin where it occurs. Proper and timely medication for this skin condition is very important. 

Henvisning til en hudlæge (specialist hudlæge) er påkrævet for patienter med Lupus Pernio.

Other Skin Lesions

The skin may produce thick bumps (nodules) and smaller bumps of a few millimeters in diameter (papules). In some cases, these bulges sit so close together that they form a sort of plate, also called plaque. These lesions most commonly occur on the extremities, face, scalp, back, and buttocks. They are usually reddish-brown in colour and are not usually symptomatic. These lesions most commonly occur on the extremities: face, scalp, back, and buttocks.

Symptomer:

  • klumper i huden
  • Farven varierer fra rød / blå til gul / rød
  • plaques føles hårde og nogle gange danner en ring på huden

Teknikker til at forstå din tilstand

Patienter med sarkoidose i huden bør vurderes for involvering af andre organer, såsom lunger og lever.

Fremgangen af hudsarkoidose varierer, sædvanligvis holde trit med sygdommens aktivitet i lungen.

I de fleste tilfælde er en hudvurdering af en hudlæge (specialisthudlæge) tilstrækkelig.

Nogle gange er det nødvendigt at tage en biopsi af huden. Din læge vil tage et test stykke hud, der skal undersøges under et mikroskop.

Undersøg din hud!

Sarcoidose kan forårsage ændringer i huden. Vær særlig opmærksom på:

  • tatoveringer;
  • gamle ar
  • Hvide eller endog mørkfarvede pletter på huden (hypo- og hyperpigmentering).

Hvis du bemærker ændringer i huden, er det klogt at få disse kontrolleret af din læge.

Behandling

Skin disorders during sarcoidosis are often spontaneous and pose no threat to general health. Therefore, full recovery is seen in many cases. However sometimes the skin is so damaged, painful or disfiguring that the patient may feel very physically or socially uncomfortable. Skin lesions take time to recover. In these cases, the dermatologist may prescribe the following medications:

Ointments or creams contain corticosteroids which suppress the inflammation of the skin. However, corticosteroids can make the skin thin and fragile in the long term.

Corticosteroid tabletter (e.g. prednisolone) may be prescribed for severely disfiguring disorders and conditions that do not heal spontaneously. The treatment with these drugs usually takes a number of months. Prescriptions will only be given in the most serious of cases due to adverse side effects of corticosteroids.

Hydroxychloroquine/Mepacrine These medicines were originally used in the treatment of malaria. Dermatologists may prescribe these drugs to treat various forms of skin sarcoidosis.

Immunsuppressive lægemidler inhibit cell division and are only prescribed if corticosteroids do not provide sufficient recovery. Methotrexate is an example of such a medication. Although your GP may be able to provide ongoing prescriptions, these medications should be supervised by a consultant dermatologist.

Sarcoidosis and Tattoos

There is a reported risk that sarcoidosis can be triggered, or existing symptoms worsened, by tattoos. A flare up is indicated by nodules appearing on the tattoo. Some patients have actually been diagnosed with sarcoidosis due to their tattoos suddenly producing raised scars. Some colours are more likely to cause problems than others.

The interaction between sarcoidosis symptoms and tattoos may be caused by either the tattoo procedure breaking the skin or the tattoo ink itself. Not all patients are affected – some may not experience any symptoms, particularly if they do not have skin sarcoidosis. 

SarcoidosisUK therefore recommends that patients with sarcoidosis do not get tattoos, particularly those patients with existing skin sarcoidosis. If you are concerned about existing tattoos or would like to discuss your options, contact the SarcoidosisUK Nurse Helpline or your GP.

Læs mereTattoo Sarcoidosis (Lyons, A., Brayman, G. & Tahhan, S. J GEN INTERN MED (2018) 33: 128.)

Page last updated: July 2019. Next review: July 2021.

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