Mast Cells in the Cutaneous Lesions of Sarcoidosis: Their Subtypes and the Relationship to Systemic Manifestations

Possible involvement of mast cells in pulmonary sarcoidosis has been suggested, however whether mast cells are involved in cutaneous sarcoidosis remains unknown. We undertook a morphological study of mast cells in the lesional skin from 17 patients with cutaneous sarcoidosis using immunohistochemical methods. Mast cells were present in non-parenchymal fibrous areas, but not in granulomatous areas, in the biopsy specimens from the cutaneous lesions. However, there were no significant differences between the number of mast cells in the lesional skin and that in non-lesional skin from the patients. Mast cells containing substantial quantities of both tryptase and chymase (MC(TC) cells) were present in 41% of the patients, and cells containing tryptase but not chymase (MC(T) cells) were present in 59% of patients. All patients of the former group showed systemic manifestations of the disease concomitantly. Serum angiotensin I-converting enzyme levels were elevated in 71.4% of the former group, and in 30% of the latter group. This study for the first time demonstrated that mast cells were present in non-parenchymal fibrous areas of the cutaneous lesions of sarcoidosis, and the mast cell subtypes may be related to systemic manifestations.