Scarring alopecia - brown skin - stock photo
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Scarring alopecia - brown skin

Scarring alopecia in a 57-year-old woman following cutaneous sarcoidosis. Fitzpatrick skin type (FST) phototype 5. Cutaneous sarcoidosis is very rare in Asian skin. Repeatedly the skin biopsy, in this case, showed granulomatous inflammation, leading to the differential diagnosis of cutaneous tuberculosis, cutaneous leishmaniasis, and leprosy, which are more common in Asia. This patient was treated with anti-TB drugs for six months without a response to therapy. Clinically this did not tally with leprosy; anti-leishmania treatment was not started as the diagnosis was not conclusive, and the IM or IV stibogluconate has a lot of side effects and is not recommended as a trial of therapy. After extensive investigations that took a year and following a trial of anti-TB therapy, an increased serum angiotensinā€converting enzyme level led to the diagnosis of cutaneous sarcoidosis. This responded dramatically to oral prednisolone. This condition may look like Discoid lupus. However, this diagnosis is clinically different and excluded due to the histopathology lab test.

Rasika Pereira

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