Abstract
Background: The pathogenesis of sarcoidosis is unknown. The skin is the second most involved organ at 30-40% of the time. The current hypothesis is that there is an antigenic trigger that causes the patients immune system to form a granulomatous response by way of a TH1 and TH17 response. There are many hypotheses as to what the trigger is (atypical mycobacterial, inhaled inorganic particles such as titanium and silica) but no conclusive evidence exists to what triggers this immunologic phenomenon. Methods: We retrospectively collected biopsy samples with a diagnosis of sarcoidosis from 2000 to present (n=10). We used a biopsy samples of granuloma annulare (n=2) and intradermal nevus (n=1) as a control. The biopsy samples were deidentified and samples were fixed, digested, and analyzed using Inductively Coupled Plasma Atomic Emission Spectrometry (ICP-AES), and Raman Spectroscopy. Results: Using ICP-AES, our samples were shown to have significant amounts of Si, Ti, and aluminum particles within the biopsy specimen. When using Raman Spectroscopy one of the sarcoidosis samples showed a significant focus of titanium within a sarcoidal granuloma. Another sarcoidosis sample showed a subtle change in the SiO2 peak. Conclusions: Inorganic particles such as titanium or silicone may be an antigenic trigger that causes granuloma formation in some sarcoidosis patients. Method of transmission may be aerosolized inhalation. Further studies with more samples are needed.
Financial Disclosure:
No current or relevant financial relationships exist.
