[Livedo-like cutaneous sarcoidosis].

Area of Science:

• Dermatology
• Internal Medicine
• Pathology

Background:

• Cutaneous sarcoidosis presents with diverse clinical manifestations.
• Livedo reticularis is an uncommon but recognized dermatological sign.

Observation:

• A 51-year-old female presented with bilateral knee livedo, polyarthralgia, malaise, weight loss, and dyspnea.
• Skin biopsy showed granulomas around dermal vessels; lab tests revealed elevated angiotensin-converting enzyme, mediastinal adenomegaly, and pulmonary fibrosis.
• The patient developed hepatic involvement and hypercalcemia, consistent with systemic sarcoidosis.

Findings:

• Systemic sarcoidosis was diagnosed based on clinical and laboratory findings.
• Treatment with systemic corticosteroids led to favorable outcomes, including laboratory normalization and symptom resolution.
• Histopathology suggests granuloma formation around arterioles contributes to livedo.

Implications:

• Livedo reticularis can be a presenting sign of systemic sarcoidosis.
• Screening for sarcoidosis should be considered in cases of atypical livedo.
• This case highlights the importance of recognizing cutaneous manifestations of systemic diseases.