SARCOIDAL FOREIGN-BODY GRANULOMATOUS DERMATITIS ASSOCIATED WITH OPHTHALMIC DROPS

Sarcoidal granulomas are found in sarcoidosis and in reactions to fore ign materials. We report the case of an 81-year-old woman with glaucom a who presented with multiple brown-black asymptomatic papules over th e chin and involving nasal mucosa and columella of 1-year duration. Bi opsy of the nasal mucosa and cutaneous papules showed sarcoidal granul omas associated with brown-black intracellular pigment within multinuc leated giant cells. Electron-probe x-ray microanalysis demonstrated hi gh sulfur content. Clinical studies showed no evidence of systemic sar coidosis. Two of three ophthalmologic drops contained sodium bisulfite ; bisulfite is known to cause allergic reactions. Although the exact s ubstance causing the granulomatous reaction is unknown, the distributi on of the lesions-nasal mucosa and columella (via the nasal lacrimal d uct) and the underlying chin-implicate the eyedrops in the production of the pigmented granulomatous nodules.