{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T05:39:47Z","timestamp":1787981987013,"version":"build-2784847793"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2004,2,6]],"date-time":"2004-02-06T00:00:00Z","timestamp":1076025600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2004,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Background\u2002<\/jats:bold> Sarcoidosis is a chronic granulomatous disease of unknown etiology. Cutaneous disease is common and includes two clinicopathologic categories: granulomatous infiltration or a reactive phenomenon. In the granulomatous infiltrative group, clinical manifestations can be variable. Ulcers in sarcoidosis are uncommonly recognized and have been categorized previously under the rubric of atrophic, necrobiosis\u2010like, or ulcerative sarcoidosis.<\/jats:p><jats:p><jats:bold>Patients and methods\u2002<\/jats:bold> We evaluated retrospectively sarcoidosis patients presenting to the Johns Hopkins Department of Dermatology between June 1989 and May 2002. Multiple skin biopsies were performed for histopathologic evaluation. Investigation for extracutaneous manifestations, including routine serologic assays, chest radiography, pulmonary function tests, electrocardiogram, and angiotensin\u2010converting enzyme level, and referral for ophthalmologic examination were performed in all patients.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Of 147 consecutive patients presenting with cutaneous sarcoidosis, seven demonstrated ulcerative\u2010atrophic sarcoidosis lesions. All patients were African\u2010American (five females and two males). All patients had ulcers surrounded by atrophic necrobiosis lipoidica\u2010like plaques on the pretibial areas. All patients had other mucocutaneous manifestations of sarcoidosis, with the majority having evidence of internal disease. Combined immunosuppressive and immunomodulatory therapy was effective in controlling the cutaneous manifestations of all patients with ulcerative sarcoidosis.<\/jats:p><jats:p><jats:bold>Conclusions\u2002<\/jats:bold> The ulcerative variant is a poorly defined subset of cutaneous sarcoidosis. Trauma, superimposed on atrophic plaques, appears to be the principal mechanism of this rare variant of cutaneous sarcoidosis.<\/jats:p>","DOI":"10.1111\/j.1365-4632.2004.01896.x","type":"journal-article","created":{"date-parts":[[2004,2,6]],"date-time":"2004-02-06T10:12:06Z","timestamp":1076062326000},"page":"108-112","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":57,"title":["Clinicopathologic features of ulcerative\u2010atrophic sarcoidosis"],"prefix":"10.1111","volume":"43","author":[{"given":"Simon S.","family":"Yoo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mimouni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga V.","family":"Nikolskaia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Kouba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel N.","family":"Sauder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos H.","family":"Nousari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,2,6]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(84)70133-2"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1997.03890430098013"},{"key":"e_1_2_7_4_2","first-page":"543","article-title":"Multiple benign sarcoid of the skin","volume":"17","author":"Boeck C","year":"1899","journal-title":"J Cut Genit Urin Dis"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1997.03890380087013"},{"key":"e_1_2_7_6_2","doi-asserted-by":"crossref","first-page":"584","DOI":"10.2340\/0001555549584587","article-title":"Leg ulcers. A report of two cases caused by sarcoidosis","volume":"49","author":"Brodkin RH","year":"1969","journal-title":"Acta Derm Venereol"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000249005"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1955.tb12731.x"},{"key":"e_1_2_7_9_2","first-page":"39","article-title":"Suppurative sarcoidosis","volume":"7","author":"Kenney RL","year":"1981","journal-title":"J Assoc Milit Dermatol"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.109.4.543"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1984.01650370099019"},{"key":"e_1_2_7_12_2","first-page":"451","article-title":"Sarcoidosis with severe extensive skin ulceration. A case report","volume":"24","author":"Schamroth JM","year":"1985","journal-title":"Int J Dermatol"},{"key":"e_1_2_7_13_2","doi-asserted-by":"crossref","first-page":"1531","DOI":"10.1001\/archderm.1987.01660350131029","article-title":"Cutaneous ulcers in sarcoidosis","volume":"123","author":"Verdegem TD","year":"1987","journal-title":"Arch Dermatol"},{"key":"e_1_2_7_14_2","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1001\/archderm.1982.01650230059030","article-title":"Generalized ulcerative sarcoidosis","volume":"118","author":"Schwartz RA","year":"1982","journal-title":"Arch Dermatol"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1970.tb15696.x"},{"key":"e_1_2_7_16_2","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1001\/archderm.1982.01650160022014","article-title":"Serum angiotensin I\u2010converting enzyme level in patients with cutaneous sarcoidal granulomas","volume":"118","author":"Callen JP","year":"1982","journal-title":"Arch Dermatol"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00406475"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.114.3.447"},{"key":"e_1_2_7_19_2","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1001\/archderm.1986.01660150098024","article-title":"Generalized atrophic sarcoidosis with ulcerations","volume":"122","author":"Hruza GJ","year":"1986","journal-title":"Arch Dermatol"},{"key":"e_1_2_7_20_2","first-page":"311","article-title":"Sarcoidosis presenting as cutaneous ulceration, subcutaneous nodules and chronic arthritis","volume":"8","author":"Boyd RE","year":"1981","journal-title":"J Rheumatol"},{"key":"e_1_2_7_21_2","first-page":"898","article-title":"Tuberculosis cutis (sarcoid)","volume":"39","author":"Sullivan M","year":"1939","journal-title":"Arch Dermatol Syph"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4725.1989.tb03609.x"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/0190-9622(91)70071-9"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-4632.2004.01896.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-4632.2004.01896.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T11:35:31Z","timestamp":1696937731000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-4632.2004.01896.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,2]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2004,2]]}},"alternative-id":["10.1111\/j.1365-4632.2004.01896.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-4632.2004.01896.x","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2004,2]]},"assertion":[{"value":"2004-02-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}