Overlapping Sarcoidosis and Atopic Dermatitis in a Black American Female: Case Report of a Rare Coexistence and Novel...

Sarcoidosis and atopic dermatitis (AD) are chronic inflammatory conditions with distinct immunologic profiles but overlapping disparities in prevalence and severity among Black Americans populations. We report a rare case of a 58-year-old Black woman with refractory cutaneous sarcoidosis and AD overlap, who presented with severely pruritic, erythematous, scaly lesions primarily on the face, scalp, and neck. Histopathologic examination revealed granulomatous inflammation. Standard topical and systemic therapies were ineffective. Initiation of upadacitinib, a selective Janus kinase (JAK) inhibitor, resulted in dramatic symptom improvement within 1 month, with a pruritus reduction from a peak pruritus Numeric Rating Scale score of 9/10 to 1/10. This case underscores the therapeutic potential of JAK inhibition in addressing convergent inflammatory pathways across traditionally distinct dermatoses, particularly in patients from populations at increased risk for treatment-refractory disease.