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DOI: 10.1055/a-0807-0594
Die Sarkoidose aus dermatologischer Perspektive
Sarcoidosis from a Dermatologist’s PerspectivePublikationsverlauf
Publikationsdatum:
12. Februar 2019 (online)
![](https://www.thieme-connect.de/media/derma/20190102/lookinside/thumbnails/997_10-1055-a-0807-0594-1.jpg)
Zusammenfassung
Die Sarkoidose ist eine seltene Multisystemerkrankung, welche durch nicht-verkäsende Granulome charakterisiert ist, die sich an verschiedenen Organen manifestieren können. Die Pathogenese der Sarkoidose ist nicht vollständig geklärt, neben genetischen Faktoren spielen auch infektiöse Triggerfaktoren sowie Umwelteinflüsse eine Rolle. Die Lunge ist bei über 90 % der Patienten betroffen und damit das am häufigsten involvierte Organ. Es folgt die Haut, die bei bis zu einem Drittel der Sarkoidose-Patienten Auffälligkeiten aufweist, welche anderen Organbeteiligungen häufig vorausgehen. Es ist daher wichtig, die Sarkoidose der Haut frühzeitig zu diagnostizieren, damit eine symptomorientierte Durchuntersuchung und Therapie in die Wege geleitet werden können. Letztere gestaltet sich oft schwierig, da evidenzbasierte Therapieempfehlungen weitgehend fehlen.
In dieser Übersichtarbeit werden die dermatologische Vielgestaltigkeit der Erkrankung, die empfohlenen fachspezifischen und fachübergreifenden Untersuchungen sowie die Therapiemöglichkeiten vorgestellt und diskutiert.
Abstract
Sarcoidosis is a rare multisystemic disease characterized by non-caseating granuloma, which can manifest in a variety of organs. The pathogenesis of sarcoidosis is largely unknown; genetic factors, microbial triggers and environmental agents appear to play a role.
While pulmonary sarcoidosis is the most abundant organ manifestation (> 90 % of patients), involvement of the skin is the most common extrapulmonary presentation of the disease that occurs in up to one third of the patients. Skin manifestations often preceed further organ involvement. It is therefore crucial to early diagnose this rare skin disease in order to initiate essential organ diagnostics to exclude or confirm extracutaneous manifestations and to eventually start therapy. Treatment of sarcoidosis remains difficult; evidence-based therapy guidelines and clinical studies are widely lacking.
Herein we describe the manifold dermatological presentations of sarcoidosis and suggest dermatologic and interdisciplinary diagnostic investigations. Based on the diagnosed manifestations we present and discuss therapeutical options.
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