title: Red eyes presenting with a fistulous lesion in the left lower extremity: a case report.
abstract: BACKGROUND
  Very few cases of scar sarcoidosis affecting the eyes and bone together have been reported in the last few years.
  
  
  METHODS
  We report a case of a 49-year-old Spanish man with recurrent bilateral granulomatous uveitis and a fistulous nodular lesion in the left pre-tibial region (scar granuloma) on the site of an 8-year-old scar. He presented with bilateral hilar adenopathies and elevation of inflammatory markers and angiotensin-converting enzyme. A histologically confirmed sarcoid of the tibia with a radiologic appearance unusual for long tubular bone involvement was observed. He also had bilateral ophthalmologic involvement.
  
  
  CONCLUSIONS
  Sarcoidosis is a disease of unknown cause histologically characterized by non-caseating granulomas that can involve any organ or tissue. Osseous sarcoidosis is a relatively rare presentation. However, on the basis of cases reported in the literature, sarcoid lesions on bones are generally asymptomatic. Biologic agents are considered an alternative therapy for sarcoidosis resistant to conventional treatment.
authors.affiliation: Rheumatology Department, Hospital General de Almansa, Av de la Circunvalacion s/n, (02640), Almansa, Albacete, Spain. npalmou@hotmail.com.
authors.forename: Natalia Palmou
authors.initials: NP
authors.lastname: Fontana
authors.affiliation: Rheumatology department, Hospital del Perpetuo Socorro, Albacete, España. ejudez@yahoo.es.
authors.forename: Enrique Judez
authors.initials: EJ
authors.lastname: Navarro
authors.affiliation: Ophthalmology Department, Hospital General de Albacete, Albacete, España. oscarmartincr@hotmail.com.
authors.forename: Oscar Martín
authors.initials: OM
authors.lastname: Melero
authors.affiliation: Traumatology Department, hospital General de Albacete, Albacete, España. slosa@jccm.sescam.es.
authors.forename: Sergio Losa
authors.initials: SL
authors.lastname: Palacios
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002921:Cicatrix / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D003937:Diagnosis, Differential; D006099:Granuloma / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D035002:Lower Extremity / Q000000981:diagnostic imaging*; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011859:Radiography; D012507:Sarcoidosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D013977:Tibia / Q000000981:diagnostic imaging; D014605:Uveitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents; D011241:Prednisone; D008727:Methotrexate