Sarcoidal foreign-body granulomatous dermatitis associated with ophthalmic drops.
Sarcoidal granulomas are found in sarcoidosis and in reactions to foreign materials. We report the case of an 81-year-old woman with glaucoma who presented with multiple brown-black asymptomatic papules over the chin and involving nasal mucosa and columella of 1-year duration. Biopsy of the nasal mucosa and cutaneous papules showed sarcoidal granulomas associated with brown-black intracellular pigment within multinucleated giant cells. Electron-probe x-ray microanalysis demonstrated high sulfur content. Clinical studies showed no evidence of systemic sarcoidosis. Two of three ophthalmologic drops contained sodium bisulfite; bisulfite is known to cause allergic reactions. Although the exact substance causing the granulomatous reaction is unknown, the distribution of the lesions--nasal mucosa and columella (via the nasal lacrimal duct) and the underlying chin--implicate the eyedrops in the production of the pigmented granulomatous nodules.
Carlson
J A
JA
Division of Dermatopathology, Albany Medical College, New York 12208, USA.
Schutzer
P
P
Pattison
T
T
Del Rosario
A
A
Mihm
M C
MC
D000368:Aged; D003872:Dermatitis / Q000209:etiology* / Q000473:pathology; D004577:Electron Probe Microanalysis; D005260:Female; D015745:Granuloma, Foreign-Body / Q000209:etiology* / Q000473:pathology; D006801:Humans; D009297:Nasal Mucosa / Q000737:chemistry / Q000473:pathology; D009883:Ophthalmic Solutions / Q000009:adverse effects*; D012507:Sarcoidosis / Q000209:etiology* / Q000473:pathology; D012867:Skin / Q000737:chemistry / Q000473:pathology; D013455:Sulfur / Q000032:analysis
D009883:Ophthalmic Solutions; D013455:Sulfur