Polymorphous cutaneous and chronic multisystem sarcoidosis

Sarcoidosis is a systemic disorder in which cutaneous findings are often prominent. These may be polymorphous to the extent that sarcoidosis may mimic many other cutaneous diseases. We describe a 56-year-old woman with involvement of the skin, eyes, bones, heart, and lung. After an initial presentation 10 years earlier of erythema nodosum with bilateral hilar adenopathy, there were three types of cutaneous changes: subcutaneous, nut-sized palpable nodules localized along the upper and lower extremities, annular plaques on the shins, and erythema nodosum-like palpable and slightly tender nodules. It is very unusual to have all three types of skin lesions, especially the erythema nodosum-like histologically specific cutaneous ones in this setting, which is what prompted this report.