Cutaneous nodular sarcoidosis with granulomatous renal sarcoid

We describe a 66-year-old lady who presented with tender nodules on her trunk and limbs which were histologically proved to be sarcoid. Following steroid therapy the skin lesions remitted, but renal failure developed due to a severe granulomatous interstitial nephritis. Clinical and biochemical improvement followed treatment with high dose steroids, although renal function and renal biopsy remained abnormal.