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February 1985

Extensive Ichthyosiform Sarcoidosis in a Patient With Juvenile Rheumatoid Arthritis

Arch Dermatol. 1985;121(2):171-172. doi:10.1001/archderm.1985.01660020029010

To the Editor.—  Cutaneous manifestations are common in sarcoidosis. Ichthyosislike changes are reported occasionally, but are limited to the extremities. A generalized ichthyosiform eruption, which proved to be sarcoidosis, developed in a patient with juvenile rheumatoid arthritis (JRA) who had taken systemic corticosteroids since infancy.

Report of a Case.—  A 23-year-old woman was seen at Northwestern University Medical Center, Chicago, because of progressive hair loss and scalp scaliness of eight years' duration that was unresponsive to topical steroids, emollients, and oral vitamin A. During the previous year, the hair loss markedly worsened and generalized scaling and pruritus developed. The patient had had seronegative polyarticular JRA since she was 1 year old, which was now controlled on a regimen of 5 mg/day of prednisone and aspirin.On examination, generalized, fine white scales overlay 1- to 3-mm yellow-brown macules that persisted with diascopy (Fig 1). In addition, extensive, patchy, nonscarring alopecia with

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