Background Definition

Sarcoidosis is a systemic, idiopathic disease characterised by the formation of non-caseating epitheliod granulomas that disrupt underlying tissue function.1 While sarcoidosis can affect virtually any organ system, pulmonary (>90%), hepatosplenic (50-80%), haematological (40%), musculoskeletal (39%), ocular (30-50%), cutaneous (25%), cardiac (5%) and neurological (5-10%) manifestations are most common.1

Cutaneous manifestations of sarcoidosis typically present at disease onset, and with the exception of erythema nodosum, do not correlate with the severity of disease. Erythema nodusum tends to be associated with acute, benign, spontaneously resolving sarcoidosis.2 Skin lesions in sarcoidosis can be divided into specific lesions (i.e. skin biopsy demonstrates non-caseating granulomas) and non-specific lesions (i.e. reactive states). Specific lesions include papules, nodules, plaques, subcutaneous nodules, infiltrative scars and lupus pernio. Plaques and papules are the most common cutaneous lesions, while lupus pernio is most specific for sarcoidosis.3 Lupus pernio tends to affect the face, manifesting as brownish-red, dusky, swollen and shiny infiltrated plaques.1

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