title: Two cases of interferon-alpha-induced sarcoidosis Koebnerized along venous drainage lines: new pathogenic insights and review of the literature of interferon-induced sarcoidosis.
abstract: Sarcoidosis is a systemic granulomatous disorder of unknown origin commonly affecting the lung, the lymphoid system and the skin. We report here two cases of cutaneous sarcoidosis in two former intravenous drug users following interferon (IFN)-α and ribavirin therapy for chronic hepatitis C. Both patients developed skin sarcoidosis along venous drainage lines of both forearms, coinciding with the areas of prior drug injections. The unique distribution of the skin lesions suggests that tissue damage induced by repeated percutaneous drug injections represents a trigger for the local skin manifestation of sarcoidosis. Interestingly, skin damage was recently found to induce the local expression IFN-α, a well-known trigger of sarcoidosis in predisposed individuals. Here we review the literature on sarcoidosis elicited in the context of IFN-α therapy and propose a new link between the endogenous expression of IFN-α and the induction of disease manifestations in injured skin.
authors.affiliation: Division of Immunology and Allergology, University of Lausanne, Lausanne, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: Buss
authors.forename: V
authors.initials: V
authors.lastname: Cattin
authors.forename: P
authors.initials: P
authors.lastname: Spring
authors.forename: R
authors.initials: R
authors.lastname: Malinverni
authors.forename: M
authors.initials: M
authors.lastname: Gilliet
mesh_terms: D000328:Adult; D003875:Drug Eruptions / Q000209:etiology; D005260:Female; D005542:Forearm / Q000098:blood supply; D019698:Hepatitis C, Chronic / Q000188:drug therapy; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects*; D016898:Interferon-alpha / Q000009:adverse effects*; D008297:Male; D012507:Sarcoidosis / Q000139:chemically induced*; D012871:Skin Diseases / Q000139:chemically induced*; D015819:Substance Abuse, Intravenous / Q000150:complications*
chemical_list: D007155:Immunologic Factors; D016898:Interferon-alpha