Cutaneous findings in systemic sarcoidosis

Diagnosis: Cutaneous findings in systemic sarcoidosis

Cutaneous findings in systemic sarcoidosis

Clinical Presentation

Cutaneous findings in systemic sarcoidosis

Clinical History

Submitted by Ellie Goulding MD. Originally posted January 23, 2017.

Treatment

See case discussion.

Differential Diagnosis

• Granuloma annulare • Foreign body granuloma • Lupus vulgaris (cutaneous TB) • Lymphoma • Rosacea • Leprosy • Tinea faciei

Key Learnings

• Non-caseating granulomatous disease of unknown etiology • Cutaneous involvement in ~25-35% of patients • Skin lesions: papules, nodules, plaques — classically red-brown to violaceous • Lupus pernio: violaceous plaques on nose, cheeks, ears — indicates chronic, severe disease • Erythema nodosum is the most common nonspecific cutaneous finding • Löfgren syndrome: bilateral hilar lymphadenopathy + erythema nodosum + polyarthralgias + fever (good prognosis) • Diascopy reveals "apple jelly" color — typical of granulomatous inflammation • Scar sarcoidosis: granulomas develop within old scars

Tags: cutaneous, findings, systemic, sarcoidosis, ellie goulding md