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Case Reports: Unusual presentation of more common disease/injury
Erythroderma with total scarring alopecia
  1. Basma Karrakchou,
  2. Amani Fliti,
  3. Mariame Meziane and
  4. Karima Senouci
  1. Dermatology and Venereology Department, Mohammed V University of Rabat, Ibn Sina Hospital, Rabat, Morocco
  1. Correspondence to Dr Basma Karrakchou; karrakchou.basma{at}gmail.com

Abstract

A woman in her 50s presented with total scarring ulcerated alopecia evolving for 10 years, and a recent budding tumour on the lower lip. Clinical examination revealed an associated exfoliated and infiltrated erythroderma with ulcerated cutaneous tumours of the legs, palmoplantar hyperkeratosis, hepatosplenomegaly and diffuse lymphadenopathies.

Dermatoscopy of the scalp, leg tumours and infiltrated skin showed a typical yellowish background overlaid by arborescent vessels and whitish areas. Cutaneous biopsies of the same areas found sarcoidotic granulomas. Lip biopsy found an associated well-differentiated squamous cell carcinoma. Investigations confirmed the diagnosis of systemic sarcoidosis with an elevated converting enzyme level, mediastinal calcified lymphadenopathies in CT scan and deep localisations in positron emission tomography scan (thyroid, lymph nodes, mediastinum, liver, spleen and adrenal glands).

The patient was treated with oral prednisone for sarcoidosis and intramuscular bleomycin followed by surgery and radiotherapy for squamous cell carcinoma. Sarcoidotic lesions healed, but a recurrence of her carcinoma led to death.

  • Dermatology
  • General practice / family medicine

https://doi.org/10.1136/bcr-2022-250782

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    Footnotes

    • Contributors BK drafted the article and managed the patient. AF managed the patient and revised the manuscript. MM supervised the manuscript redaction and approved the final version of the manuscript. KS supervised the clinical management of the case and revised critically the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.