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Cutaneous manifestations of sarcoidosis

Steven Prystowsky, MD
Miguel Sanchez, MD
Section Editor
Jeffrey Callen, MD, FACP, FAAD
Deputy Editor
Abena O Ofori, MD


Sarcoidosis is a granulomatous disease characterized by the presence of noncaseating granulomas in organs and tissue, such as the skin, lung, lymph nodes, eyes, joints, brain, kidneys, and heart. Cutaneous lesions may present with a variety of morphologies, including papules, nodules, plaques, and infiltrated scars.

The diagnosis of cutaneous sarcoidosis is supported by the recognition of compatible clinical features, the detection of classic histopathologic findings, and the exclusion of other granulomatous disorders. Compared with other sites of sarcoidal involvement, histopathologic sampling of lesions in the skin is a relatively simple and safe procedure. When present, cutaneous lesions can be a valuable asset in the confirmation of a diagnosis of sarcoidosis.

In addition to skin lesions that display noncaseating granulomas on biopsy, cutaneous eruptions that are not specific for sarcoidosis also may occur in patients with sarcoidosis. Erythema nodosum is the most frequent nonspecific cutaneous disorder associated with sarcoidosis.

The clinical manifestations and diagnosis of cutaneous sarcoidosis will be discussed here. The management of cutaneous sarcoidosis, the pathogenesis of sarcoidosis, and the clinical features, diagnosis, and treatment of extracutaneous sarcoidosis are reviewed elsewhere. (See "Management of cutaneous sarcoidosis" and "Pathology and pathogenesis of sarcoidosis" and "Clinical manifestations and diagnosis of pulmonary sarcoidosis" and "Treatment of pulmonary sarcoidosis: Initial therapy with glucocorticoids" and "Treatment of pulmonary sarcoidosis: Disease refractory to glucocorticoid therapy".)


Skin manifestations of sarcoidosis are estimated to occur in approximately 25 percent of patients [1-6] and are divided into specific and nonspecific lesions based upon histopathologic features [7]. Specific skin lesions contain noncaseating (sarcoidal) granulomas, which represent the classic histopathologic findings in lesional tissue. All other cutaneous findings associated with sarcoidosis are classified as nonspecific. Patients may have both specific and nonspecific skin findings [8].

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