Generalized atrophic sarcoidosis with ulcerations

A 53-year-old man presented to the Manhattan (NY) Veterans Administration Hospital with a 20-year history of generalized atrophic lesions associated with lower extremity ulcerations. Cutaneous biopsy specimens and other laboratory data confirmed the diagnosis of sarcoidosis involving the skin, lungs, eyes, joints, bones, pituitary gland, gonads, and liver. To our knowledge, generalized atrophic sarcoidal lesions have not been described previously in the English literature. Ulcerated cutaneous sarcoidal lesions, though recognized, are only rarely seen in the disease. The ulcerations, but not the atrophic lesions, responded to prednisone therapy.