Kutane Sarkoidose

ZUSAMMENFASSUNG

Die Sarkoidose ist eine Multisystemerkrankung, deren Ursache bislang ungeklärt ist. Pathognomonisch sind nicht verkäsende Granulome, die alle Gewebe oder Organsysteme betreffen können. Aufgrund der guten klinischen Sichtbarkeit der kutanen Sarkoidose ist diese oft der erste Hinweis für das Vorliegen einer systemischen Sarkoidose. Die Dermatologie spielt somit eine wichtige Rolle bei der Früherkennung dieser multisystemischen Erkrankung. Eine reine Hautmanifestation ohne systemische Beteiligung ist möglich. Die häufigsten Vertreter hierfür sind die makulopapulöse und die noduläre Sarkoidose. Zum anderen gibt es unspezifische Hautmanifestationen, wie zum Beispiel das Erythema nodosum, welches im Rahmen einer systemischen Sarkoidose auftreten kann. Die Diagnose wird mittels Gewebebiopsie gestellt. Die Biomarker CRP, sIl-2R und Neopterin können bei Hautmanifestation Hinweis für eine systemische Beteiligung sein. Die Therapie richtet sich nach Schwere der Hautmanifestation und systemischer Beteiligung. Zur Behandlung der kutanen Sarkoidose zugelassen sind topische, intraläsionale oder systemische Glukokortikosteroide. Bei therapierefraktären Verläufen können off-label immunmodulierende oder immunsuppressive Medikamente eingesetzt werden.

Schlüsselwörter

Kutane Sarkoidose - Erythema nodosum - Lupus pernio - Darier-Roussy-Sarkoidose - makulopapulöse Sarkoidose

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