Nodular Subcutaneous Sarcoidosis

Sarcoidosis has been described as a widespread noncaseating epithelioid cell granulomatous multisystem disease involving the lungs, liver, myocardium, bone, eyes, kidneys, salivary glands, skin, and reticuloendo-thelial systems. 1-4 Manifestations in the skin occur frequently and with a variable incidence. 3-5 Subcutaneous nodules as the only presenting dermatological manifestation of sarcoidosis are a distinctly rare occurrence.6 This report describes a patient with subcutaneous nodules that subsequently proved to be due to sarcoidosis. Report of a Case A 20-year-old black man was admitted to the University of Michigan (Ann Arbor) Medical Center with a complaint asymptomatic of "lumps" on his body. He also experienced exertional dyspnea, cough, and a 6.75-kg weight loss over an eight-month period of time prior to admission.He denied exposure to respiratory irritants, drugs, or tuberculosis. The skin examination revealed 1- to 2-cm nonerythematous, firm, subcutaneous nodules on the head, neck, chest, back, groin, and bilateral upper and lower extremities (Fig 1). The skin overlying these nodules was nonulcerated and freely mobile. Generalized adenopathy (2- to 3-cm firm, nontender nodes) was also present. The lungs and heart were normal. The liver