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| Fig. 62.7 Multiple sarcoidal granulomas along the right eyelid, nasal margin, and lower lip in a patient with sarcoidosis. (Courtesy of Whitney A. High, MD) |
Cutaneous sarcoidosis is a granulomatous process of unknown etiology that is more prevalent among blacks, particularly among those in the southern United States, where the incidence is 3 to 4 times that of appropriately matched white patients. The cause of the disease is unknown. Cutaneous lesions may occur in association with pulmonary disease, or may be present in isolation. Diverse patterns of skin lesions occurring in black patients with sarcoidosis have been observed. Shiny, somewhat waxy papular lesions are the most frequent cutaneous manifestation of sarcoidosis in blacks. When such dermal granulomatous papules are located near the nose, the condition has been referred to as
lupus pernio (Fig. 62-7), and it may be indicative of a higher association with pulmonary disease (for photos, see
interactive reference). Because of its protean cutaneous manifestations, sarcoidosis should be included in the differential diagnosis of nearly all chronic dermatoses in black patients.
