Sarcoidosis of the upper respiratory tract and its relation to lupus pernio

The authors present a personally studied series of 32 patients with sarcoidosis affecting the upper respiratory tract and nose. Twenty-five of these patients had lupus pernio (LP), which in 8 instances was accompanied by sarcoidosis of the upper respiratory tract (SURT). The 7 other patients had SURT (mucosal disease) without LP. There was a female to male ratio of 7:1. SURT presented mainly in the third decade, whereas LP presented mainly in the fourth and fifth. Despite this, SURT was as much a chronic manifestation of sarcoidosis as LP. Five of 11 patients (45%) presenting with SURT progressed to LP within 2 yr. Overall 26 patients (81%) had intrathoracic sarcoidosis, 19 patients (59%) had skin lesions other than LP, 10 patients (31%) had bone sarcoidosis, 7 patients (22%) had ocular lesions, and 6 patients (19%) had peripheral lymphadenopathy. The Kveim-Siltzbach skin-test was positive in 12 of 12 patients with SURT, making it a useful aid in the differential diagnosis of sarcoid granulomas in the nose. Two patients had nasal perforations, both of which followed a submucous resection.