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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 65-year-old man was admitted to the respiratory department of our hospital&#44; for the detail investigation of bilateral hilar lymphadenopathy&#46; Examination by lung computed tomography revealed lymph node adenopathy &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; and bronchoscopic lung biopsy revealed non-caseating epithelioid granulomas&#44; and thus he was diagnosed with sarcoidosis&#46; Also&#44; he was suffering from diabetes mellitus for five years previously&#46; During admission&#44; he was referred to our department complaining of itchy eruptions of the upper limbs and ears&#46; He stated that he was diagnosed with psoriasis eight years previously and treated with topical corticosteroids but without sufficient effects&#46; On physical examination&#44; scaly erythematous plaques were scattered on the knees&#44; elbows&#44; fingers and ears&#46; Nail involvement was not observed&#44; and he had no arthritis&#46; Skin lesions suggestive of sarcoidosis were not seen on the scalp&#44; trunk and extremities including the knee&#46; Results of laboratory examination elevated serum angiotensin converting enzyme &#40;34&#46;0 U&#47;ml&#44; normal&#59; 8&#46;3-21&#46;4&#41;&#44; sIL-2R &#40;1850 U&#47;ml&#44;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;4</span></a> normal&#59; 121-613&#41; and negative tuberculin reaction&#46; Neither ocular nor cardiac sarcoidosis was detected in detailed examination&#46; Histological examination from the knee lesion showed regular epidermal proliferation&#44; intraepidermal neutrophil infiltration&#44; parakeratosis&#44; dilated vessels in the dermal papilla&#44; and perivascular cellular infiltrates&#46; CD4<span class="elsevierStyleSup">&#8722;</span> and CD8<span class="elsevierStyleSup">&#43;</span> T-cells were detected in the epidermis and upper dermis&#46; Sarcoid granulomas were not observed in the dermis or subcutis&#46; The patient was treated with topical corticosteroid ointment&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The present patient first developed psoriasis&#44; and five years later the diagnosis of sarcoidosis was made&#46; He had been treated with topical therapy only&#44; therefore it is unexpected that sarcoidosis was induced by medications for psoriasis&#46; He had ocular and lung sarcoidosis&#44; whereas cutaneous sarcoidal lesions were not observed&#44; at least at the initial visit to our department&#46; To date&#44; several cases of co-existence of psoriasis and sarcoidosis have been reported<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46; Those cases usually present both cutaneous psoriatic and sarcoidal skin lesion&#44; whereas our patient did not exhibit cutaneous sarcoidosis&#46; T helper&#40;Th&#41;1 type cytokines are favored in the initial phase of sarcoidosis&#46; In particular&#44; tumor necrosis factor &#40;TNF&#41;-&#945; is important in the formation of sarcoidal granuloma<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; A shared TNF-&#945;-mediated pathogenesis between psoriasis and sarcoidosis may exist&#46; TNF-&#945; activates Th17 cells to lead Interleukin &#40;IL&#41;-17 production&#44; and IL-17 inflammatory pathway has been suggested to be important in psoriasis&#46; Also&#44; recent studies have suggested an important role of IL-17 in sarcoidosis&#44; and enhanced expression of IL-17A<span class="elsevierStyleSup">&#43;</span> interferon-&#947;<span class="elsevierStyleSup">&#43;</span> and IL-17A<span class="elsevierStyleSup">&#43;</span> IL-4<span class="elsevierStyleSup">&#43;</span> memory T cells was shown in sarcoidal lungs<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46; Thus&#44; Th17 profile has been implicated to play a role in sarcoidosis&#44; possibly by inducing granuloma formation <span class="elsevierStyleItalic">via</span> suppression of regulatory T cells<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46; Another study showed upregulation of IL-23 and IL-21 in the lesions of cutaneous sarcoidosis<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#46; In addition&#44; pso p27 is a protein detected in mast cells in psoriatic lesions and extractable from psoriatic scales&#46; Pso p27 is abundantly expressed in psoriatic lesional skin&#44; and also expression of pso p27 is increased in the lungs of pulmonary sarcoidosis <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a><a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#46; Role of pso p27 in sarcoidosis needs further studies&#46;</p></span>"
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Case and Research Letters
Plaque psoriasis in a patient with sarcoidosis
Psoriasis en placa en un paciente con sarcoidosis
M. Ishikawa
Corresponding author
ishimasa@fmu.ac.jp

Corresponding author.
, T. Yamamoto
Departamento de Dermatología, Fukushima Medical University, Fukushima, Japan
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 65-year-old man was admitted to the respiratory department of our hospital&#44; for the detail investigation of bilateral hilar lymphadenopathy&#46; Examination by lung computed tomography revealed lymph node adenopathy &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41; and bronchoscopic lung biopsy revealed non-caseating epithelioid granulomas&#44; and thus he was diagnosed with sarcoidosis&#46; Also&#44; he was suffering from diabetes mellitus for five years previously&#46; During admission&#44; he was referred to our department complaining of itchy eruptions of the upper limbs and ears&#46; He stated that he was diagnosed with psoriasis eight years previously and treated with topical corticosteroids but without sufficient effects&#46; On physical examination&#44; scaly erythematous plaques were scattered on the knees&#44; elbows&#44; fingers and ears&#46; Nail involvement was not observed&#44; and he had no arthritis&#46; Skin lesions suggestive of sarcoidosis were not seen on the scalp&#44; trunk and extremities including the knee&#46; Results of laboratory examination elevated serum angiotensin converting enzyme &#40;34&#46;0 U&#47;ml&#44; normal&#59; 8&#46;3-21&#46;4&#41;&#44; sIL-2R &#40;1850 U&#47;ml&#44;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;4</span></a> normal&#59; 121-613&#41; and negative tuberculin reaction&#46; Neither ocular nor cardiac sarcoidosis was detected in detailed examination&#46; Histological examination from the knee lesion showed regular epidermal proliferation&#44; intraepidermal neutrophil infiltration&#44; parakeratosis&#44; dilated vessels in the dermal papilla&#44; and perivascular cellular infiltrates&#46; CD4<span class="elsevierStyleSup">&#8722;</span> and CD8<span class="elsevierStyleSup">&#43;</span> T-cells were detected in the epidermis and upper dermis&#46; Sarcoid granulomas were not observed in the dermis or subcutis&#46; The patient was treated with topical corticosteroid ointment&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The present patient first developed psoriasis&#44; and five years later the diagnosis of sarcoidosis was made&#46; He had been treated with topical therapy only&#44; therefore it is unexpected that sarcoidosis was induced by medications for psoriasis&#46; He had ocular and lung sarcoidosis&#44; whereas cutaneous sarcoidal lesions were not observed&#44; at least at the initial visit to our department&#46; To date&#44; several cases of co-existence of psoriasis and sarcoidosis have been reported<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46; Those cases usually present both cutaneous psoriatic and sarcoidal skin lesion&#44; whereas our patient did not exhibit cutaneous sarcoidosis&#46; T helper&#40;Th&#41;1 type cytokines are favored in the initial phase of sarcoidosis&#46; In particular&#44; tumor necrosis factor &#40;TNF&#41;-&#945; is important in the formation of sarcoidal granuloma<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; A shared TNF-&#945;-mediated pathogenesis between psoriasis and sarcoidosis may exist&#46; TNF-&#945; activates Th17 cells to lead Interleukin &#40;IL&#41;-17 production&#44; and IL-17 inflammatory pathway has been suggested to be important in psoriasis&#46; Also&#44; recent studies have suggested an important role of IL-17 in sarcoidosis&#44; and enhanced expression of IL-17A<span class="elsevierStyleSup">&#43;</span> interferon-&#947;<span class="elsevierStyleSup">&#43;</span> and IL-17A<span class="elsevierStyleSup">&#43;</span> IL-4<span class="elsevierStyleSup">&#43;</span> memory T cells was shown in sarcoidal lungs<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46; Thus&#44; Th17 profile has been implicated to play a role in sarcoidosis&#44; possibly by inducing granuloma formation <span class="elsevierStyleItalic">via</span> suppression of regulatory T cells<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46; Another study showed upregulation of IL-23 and IL-21 in the lesions of cutaneous sarcoidosis<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#46; In addition&#44; pso p27 is a protein detected in mast cells in psoriatic lesions and extractable from psoriatic scales&#46; Pso p27 is abundantly expressed in psoriatic lesional skin&#44; and also expression of pso p27 is increased in the lungs of pulmonary sarcoidosis <a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a><a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#46; Role of pso p27 in sarcoidosis needs further studies&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Ishikawa M&#44; Yamamoto T&#46; Psoriasis en placa en un paciente con sarcoidosis&#46; Actas Dermosifiliogr&#46; 2021&#59;112&#58;865&#8211;866&#46;</p>"
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Article information
ISSN: 15782190
Original language: English
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