The cutaneous manifestations of sarcoidosis occur in ~30%1 (range 9-37%) 3 of patients with sarcoidosis. A skin lesion may be the initial presentation of sarcoidosis and the majority of patients with cutaneous manifestations will have pulmonary disease.
Pathology
Common lesions
- maculopapular lesion
- most common lesion seen in sarcoidosis
- usually on the face and neck
- often transient
-
erythema nodusum
- painful red nodular rash
- not specific for sarcoidosis
- more common in women then men and in northern Europeans
- associated with a more favorable prognosis
- granulomata
- non-caseating subcutaneous granulomata
- common on the forearms
- plaques
- lupus pernio
- most characteristic skin lesion of sarcoidosis
- red or violaceous indurated skin lesion usually on the face 3
- more common in women then men and individuals with black skin
- invades deeper soft tissues including underlying bone
- associated with:
- more aggressive disease course
- bone cysts
- sarcoidosis of the upper respiratory tract (SURT)
- uveitis
- scar sarcoidosis
- granulomatous infiltration into scars
- common in the knee
Less common lesions
- ulcerative lesions
- psoriform plaques
- hypopigmentation
- alopecia
- papillomatous lesions
- lichenoid lesions
- pustular folliculitis
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