Cutaneous sarcoidosis in Caucasians

One hundred eighty-eight Caucasian patients with cutaneous sarcoid lesions were studied prospectively. Twenty-five had erythema nodosum, while 163 had infiltrative cutaneous lesions. One hundred thirty-eight patients had systemic as well as cutaneous lesions, and fifty had cutaneous lesions only. All types of clinical lesions were seen among patients with cutaneous lesions only. The extent of cutaneous lesions did not correlate with the extent of systemic disease. Papular lesions were relatively uncommon and occurred as the only manifestation of the disease or were associated with hilar adenopathy and acute disease. Lupus pernio, scar infiltrates, and plaque lesions were the most common clinical lesions and were typically chronic and commonly associated with pulmonary mottling and/or fibrosis. Forty-eight of 127 had a histologically positive Kveim test. Among patients followed for more than 2 years, dinitrochlorobenzene (DNCB) sensitivity was higher among those with acute disease than among those with chronic disease. Seventy-nine patients with infiltrative cutaneous lesions were followed until the cutaneous lesions had healed. Those with lupus pernio were often left with unsightly telangiectatic scars, while the other types of lesions left either pale, slightly depressed scars or no scars at all.