Generalized atrophic sarcoidosis with ulcerations.

Area of Science:

• Dermatology
• Internal Medicine
• Pathology

Background:

• Sarcoidosis is a multisystem inflammatory disease of unknown etiology.
• Cutaneous involvement is common, but generalized atrophic lesions are exceptionally rare.
• Lower extremity ulcerations in sarcoidosis are also infrequently reported.

Observation:

• A 53-year-old male presented with a 20-year history of generalized atrophic skin lesions and lower extremity ulcerations.
• Biopsy and laboratory data confirmed sarcoidosis affecting skin, lungs, eyes, joints, bones, pituitary, gonads, and liver.
• The patient's generalized atrophic lesions were a novel finding in English literature.

Findings:

• Diagnosis of multisystem sarcoidosis confirmed.
• Generalized atrophic cutaneous sarcoidal lesions represent a previously undescribed manifestation.
• Ulcerated lesions responded to prednisone; atrophic lesions did not.

Implications:

• Highlights the diverse and rare presentations of sarcoidosis.
• Suggests differential treatment response between atrophic and ulcerative sarcoidal lesions.
• Underscores the importance of thorough investigation in complex dermatological cases.