Sarcoidosis and your skin: Signs and symptoms
What are the signs of sarcoidosis?
About 20% of people who get sarcoidosis develop signs of the disease on their skin1. The following pictures show some of the ways that this disease can show up on the skin.
As you look at these pictures, keep in mind that many of these signs can occur when something else is going on inside your body. A rash could mean that you have a skin infection that can be cured with medication. Tiny bumps within a tattoo could be a sign of an allergic reaction.
Any changes to your skin, including those shown in the following pictures, should be examined by a board-certified dermatologist.
Pictures of sarcoidosis on the skin
Raised patches, deep lumps, or open sores
This is a common sign of sarcoidosis. The medical name for this sign is lupus pernio.
Unlike other signs that develop on the skin, this one only appears in people who have sarcoidosis. African American women are most likely to see this sign on their skin.
The patches and deep lumps tend to be red or reddish-purple. Some feel scaly.
Lupus pernio often appears on the nose and cheeks, but it can develop elsewhere. Some people get it on their lips, ears, fingers, or toes. While the patches and lumps are noticeable, they rarely cause any symptoms, such as pain or itch.
Lupus pernio often appears on the nose and cheeks
Common signs of sarcoidosis are raised patches, deep lumps, and sometimes open sores. The medical name is Lupus pernio.
Treatment is important, though. The patches can grow together, forming one large lesion that covers the nose and cheeks. If this happens, lumps and sores can develop inside the nose, causing nosebleeds and crusting around the nose. Without treatment, the lumps may spread to the respiratory tract, which can make breathing difficult or impossible.
Smooth bumps or growths
This is another common sign of sarcoidosis, especially among African American women. The medical name is papular sarcoidosis.
Mostly painless, these bumps and growths tend to develop on the face or neck, and often appear around the eyes. You may see lesions that are skin-colored, red, reddish-brown, violet, or another color. When touched, most bumps and growths tend to feel hard.
These bumps and growths tend to clear on their own without causing a scar.
Papular sarcoidosis often appears on the face, neck, or around eyes
This is another common sign of sarcoidosis, especially among African American women. Mostly painless, these smooth bumps and growths tend to develop on the face or neck, and often around the eyes.
Rash
The medical term for this warning sign of sarcoidosis depends on whether you have symptoms.
Erythema nodosum (rash only)
Löfgren syndrome (rash with symptoms)
Lögren syndrome is more common in women who are Scandinavian, Irish, or Japanese.
When this rash appears, it’s often sudden. You may also have a fever, joint pain, swelling in your ankles or other joints, or shortness of breath. Some people feel extremely tired. The rash often feels warm and tender to the touch. Along with the rash, you may also feel lumps in your skin, which can be painful. These lumps often develop on the shins.
If you develop this rash or Löfgren syndrome, it often indicates that the sarcoidosis will clear on its own within a few weeks to months. The sarcoidosis can also come and go for a few years, but it rarely becomes serious.
When this rash appears, it’s often sudden
The rash can appear on both lower legs and sometimes the arms.
Scar
As shown in this picture, sarcoidosis can look like a scar. The patch shown here appears on a woman’s arm, but this patch can also develop on the face, scalp, back, buttocks, or leg.
The medical name for this sign is plaque sarcoidosis.
Plaque sarcoidosis often looks like a scar
Plaque sarcoidosis on this woman's arm appears as a flat-topped, slightly raised patch.
Some people have one patch, but it’s also possible to have many patches. Whether you have one patch or many, they tend to be reddish-brown or violet.
If a patch feels scaly, it can look like psoriasis or lichen planus.
Change to a scar, tattoo, or piercing
Sarcoidosis can develop in a scar, tattoo, or body piercing. When it does, it often causes redness and swelling, as shown in this picture. The affected skin may also feel lumpy, firmer than normal, sore, or itchy.
The medical name for this is scar sarcoidosis.
A change to a scar, tattoo, or body piercing may be the only sign of sarcoidosis. If you notice any change to a scar, tattoo, or body piercing, see a board-certified dermatologist. This change can be a sign of other skin problems, including an allergic reaction.
Scar sarcoidosis
A change to a scar, tattoo, or body piercing may be the only sign of sarcoidosis.
Nail changes
When you see nail changes, this is a sign that the person has had sarcoidosis for some time. Sarcoidosis can cause many nail changes, including pits in the nails and discoloration. As the disease worsens, the nails can disappear and the fingertips swell, as shown here.
Nail changes
As sarcoidosis worsens, the nails can disappear and the fingertips swell.
Some signs of sarcoidosis that appear on the skin are more common in certain people. You can find out who has a higher risk of getting this disease at, Sarcoidosis and your skin: Who gets & causes
Images
Images used with permission of Journal of the American Academy of Dermatology or JAAD Case Reports:
Images 2, 7: J Am Acad Dermatol. 2012; 66:699.e1-8.
Image 3: J Am Acad Dermatol. 2013; 68:765-73.
Image 5: JAAD Case Reports. 2017; 3:522-3.
Image 6: JAAD Case Reports. 2016; 2:146-9.
References
Haimovic A, Sanchez M, et al. “Sarcoidosis: A comprehensive review and update for the dermatologist. Part I. Cutaneous disease.” J Am Acad Dermatol. 2012; 66:699.e1-18.
Howard A and White CR, Jr. “Non-infectious granulomas.” In: Bolognia JL, et al. Dermatology. (second edition). Mosby Elsevier, Spain, 2008: 1421-6.
Marchell RM, Theirs B, et al. “Sarcoidosis.” In: Wolff K, Goldsmith LA, et al. Fitzpatrick’s Dermatology in General Medicine (seventh edition). McGraw Hill Medical, New York, 2008: 1484-93.
1Haimovic A, Sanchez M, et al. “Sarcoidosis: A comprehensive review and update for the dermatologist. Part I. Cutaneous disease.” J Am Acad Dermatol. 2012; 66:699.e1-18.