title: The sarcoidal granuloma: A unifying hypothesis for an enigmatic response.
abstract: Although the cause of sarcoidosis is unknown, there is growing support for the concept that sarcoidal granulomas result from a hypersensitivity reaction producing a nonspecific response to an extrinsic or intrinsic (autoimmune) antigen in genetically susceptible individuals. The immune milieu associated with these antigens, localized in a specific cutaneous area, produces a variant of Ruocco's "immunocompromised district." This may explain the predilection for sarcoidal granulomas in association with foreign bodies, tattoos, herpes zoster-affected dermatomes, and scars. Similar antigenic stimulation produces sarcoidal granulomas surrounding internal tumors. Finally, systemic sarcoidosis, as manifested by hilar adenopathy, may reflect the lymphatic spread of foreign antigens.
authors.affiliation: University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216.
authors.forename: Jeff
authors.initials: J
authors.lastname: Mahony
authors.affiliation: Department of Dermatology, University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216.
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Helms
authors.affiliation: Department of Dermatology, University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216; Department of Pathology, University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216; Department of Dermatology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave Rochester, NY 14642. Electronic address: rbrodell@umc.edu.
authors.forename: Robert Thomas
authors.initials: RT
authors.lastname: Brodell
mesh_terms: D002921:Cicatrix / Q000276:immunology; D005547:Foreign Bodies / Q000276:immunology; D006099:Granuloma / Q000276:immunology*; D006801:Humans; D012507:Sarcoidosis / Q000276:immunology*; D012871:Skin Diseases / Q000276:immunology*; D013653:Tattooing / Q000009:adverse effects