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SARCOIDOSIS和皮膚

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).

此頁面上的信息是在結節病專家的幫助下編制的 S. Walsh博士,倫敦國王學院醫院皮膚科顧問。

紅斑結節

結節性紅斑是最常見的結節病相關皮膚病。它通常以疾病的急性形式發生。

症狀:

  • 突然發紅,疼痛的腫塊,通常在小腿或手臂上
  • 常伴有發燒,疲勞和關節疼痛

治療:

  • 經常在3到6週後自發改善,像撲熱息痛和布洛芬這樣的簡單止痛藥可以幫助解決症狀
  • 紫藍色可能會在幾週內保持可見狀態
  • 在6個月內,80%的病例完全癒合,沒有疤痕

大多數結節性紅斑患者俱有結節病以外的病症(例如細菌或真菌感染)。此外,某些藥物可能會導致它。這種皮膚狀況並不總是自動表明結節病。

下載宣傳單:

結節病和皮膚:

狼瘡Pernio

狼瘡Pernio也可發生在結節病中。

症狀:

  • 藍色/紅色扁平變色,或腫脹,通常跨越鼻樑和臉頰
  • 皮膚疼痛
  • 淺表病變
  • 發生在面部,耳朵,手指或腳趾上

治療:

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. 

Lupus Pernio患者需要轉診給皮膚科醫生(專科皮膚科醫生)。

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.

症狀:

  • 皮膚腫塊
  • 顏色從紅色/藍色到黃色/紅色不等
  • 斑塊感覺很硬,有時會在皮膚上形成一個環

了解您的情況的技巧

應評估皮膚結節病患者是否涉及其他器官,如肺和肝臟。

皮膚結節病的進展各不相同,通常與肺部的疾病活動保持同步。

在大多數情況下,皮膚科醫生(專科皮膚科醫生)對皮膚進行審查就足夠了。

有時需要對皮膚進行活組織檢查。你的醫生會在顯微鏡下檢查一塊皮膚。

檢查你的皮膚!

結節病可導致皮膚變化。特別注意:

  • 紋身;
  • 舊傷疤;
  • 皮膚上有白色甚至深色斑點(低色素沉著和色素沉著過度)。

如果您發現皮膚有任何變化,最好由醫生檢查。

治療

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.

皮質類固醇片 (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.

免疫抑製藥物 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 結節病英國護士幫助熱線 or your GP.

閱讀更多Tattoo 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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