The spectrum of dermatological disorders found in patients with sarcoidosis presenting to the dermatology outpatient clinic at the Chris Hani Baragwanath Academic Hospital

Mbuqe-Limba, Babalwa Phindiswa Zinziswa
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Backgrounds There is a paucity of studies on cutaneous sarcoidosis in the South African setting, with the last study published 18 years ago. More studies are needed to explore these gaps to inform referral policy and guidelines for early diagnosis and management of cutaneous sarcoidosis in the country. Objectives The study focuses on the patterns of cutaneous sarcoidosis, demographic features, and histological associations with the clinical patterns of skin sarcoidosisfound in patients with sarcoidosis presenting to the dermatology outpatient clinic at the Chris Hani Baragwanath Academic hospital. In addition, the pattern, chronicity and severity of the cutaneous manifestations were described. Furthermore, the co-existence of HIV/AIDS and sarcoidosis was also examined. Methods A retrospective descriptive studythat spans from 1991 to 2015, was carried out which included cases that had a definitive diagnosis of sarcoidosis. One hundred case records of patients with cutaneous sarcoidosis that attended the Dermatology Outpatient Clinic, from the study site in Soweto, in the south of Johannesburg, were collected and transferred to a collection data sheet. Results In this predominantly Black African population, women above 45 years old (70%), were most commonly affected. Papules (68.8%) and plaques (27.1%) were the most frequent skin findings in Black Africans. The most frequent extra-cutaneous organ affected was the lung (53%). Subcutaneous lesions were found to be significantly associated (p-value <0. 012) with Scadding stage 0 and stage 4 lung involvement. On histology 70% of the cases had clean granulomas, frequently associated with papules clinically. HIV seropositive and sarcoidosis cases demonstrated an inversely proportional association with the CD4 count, with disease progression noted with CD4 increments after initiation of therapy. Conclusion The variations in the patterns of presentation revealed in this study can improve our knowledge of cutaneous patterns of sarcoidosis in this study population and assist with the development of prompt diagnosis and early treatment intervention.
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Master of Medicine in the branch of Internal Medicine (Dermatology). Johannesburg 2017.