Multisystemic Sarcoidosis Presenting as Pretibial Leg Ulcers

Area of Science:

• Dermatology
• Rheumatology
• Internal Medicine

Background:

• Sarcoidosis is a multisystemic inflammatory disease of unknown cause.
• Cutaneous manifestations occur in up to 30% of patients.
• Ulcerating sarcoidosis presenting as leg ulcers is uncommon and can mimic other chronic ulcer types.

Observation:

• A 45-year-old female with known chronic multisystemic sarcoidosis presented with pretibial leg ulcers.
• Extensive workup excluded other common etiologies for the leg ulcers.
• Histological examination of the ulcers revealed nonspecific inflammatory findings.

Findings:

• The diagnosis of nonspecific leg ulcers secondary to sarcoidosis was confirmed.
• Treatment with oral prednisolone and diligent ulcer care led to complete healing within six months.
• This case demonstrates that sarcoidosis can cause leg ulcers even in the absence of characteristic sarcoid granulomas on biopsy.

Implications:

• Sarcoidosis should be considered in the differential diagnosis of chronic leg ulcers, particularly when typical causes are ruled out.
• Nonspecific histological findings do not exclude sarcoidosis as the underlying etiology for leg ulcers.
• Effective management involves addressing the systemic disease and providing optimal wound care for ulcer healing.