Sarcoidosis and your skin: Diagnosis and treatment
When sarcoidosis develops on the skin, it’s often an early sign of the disease. As such, a dermatologist is often the first doctor to notice signs of sarcoidosis.
Signs and symptoms of sarcoidosis can come and go
Keeping track of your symptoms can help your doctors find sarcoidosis.
How do dermatologists diagnose sarcoidosis?
If you have sarcoidosis, it can take time to get the diagnosis. There is no one medical test, such as a blood test or x-ray, which can tell a doctor that you have this disease.
If you are already seeing a dermatologist, you may need to see other specialists for testing. Sarcoidosis can develop in different organs, including the lungs, eyes, or liver.
Your dermatologist can play a role in diagnosing sarcoidosis by carefully examining your skin for:
Lumps, bumps, and other signs
Scars and tattoos (sarcoidosis can develop in one)
Lymph nodes near your lumps and bumps
During this skin exam, your dermatologist is looking for granulomas. This is the medical word for masses of inflamed tissue. On the skin, granulomas can appear in many different ways. Your dermatologist will look for these.
If your dermatologist sees something suspicious, you’ll need a skin biopsy. Your dermatologist can quickly and safely perform this during your office visit. During a skin biopsy, you remain awake while your dermatologist removes a bit of the afflicted skin. The removed skin will be examined under a microscope.
While a skin biopsy cannot tell your dermatologist whether you have sarcoidosis, it can rule out other diseases, such as an infection. Sarcoidosis is diagnosed by ruling out other diseases that have similar signs and symptoms.
A diagnosis of sarcoidosis usually comes after seeing the necessary specialists who will run tests and compare your results.
How do dermatologists treat sarcoidosis on the skin?
If you have mild skin disease, your dermatologist may suggest that you let your skin clear on its own. Clearing of mild disease can take a few weeks to a few years.
Dermatologists often recommend treatment when:
Sarcoidosis can lead to thickening skin or scarring
Certain signs of sarcoidosis appear, such as smooth bumps and growths
Much of your skin is covered
Symptoms, such as pain or itch, occur
When treatment is recommended, you will receive a treatment plan tailored to your needs. Treatment plans vary with the signs of sarcoidosis on your skin, how much of your skin is covered, your overall health, age, and other considerations.
If you have a few lesions on your skin, a corticosteroid may be all you need. Most patients apply this medication to their skin twice a day. Other times, your dermatologist will inject the corticosteroid directly into the lesions.
Some patients need more aggressive treatment. You may receive a prescription for a medication used to prevent or treat malaria. These medications can be very effective for treating sarcoidosis on the skin. Other medications that can be prescribed include methotrexate, an antibiotic, or prednisone.
Laser or light therapy may be another option. For this to be effective, you may need many treatments, and your dermatologist may need to try a few different types of laser of light treatments to find one that’s right for you. Lasers and light therapies can cause side effects, including changes to your skin color, bleeding, and crusting.
On the skin, sarcoidosis can be stubborn. The first treatment that your dermatologist prescribes may not work. To get results, your dermatologist may add another treatment or change your treatment plan.
What is the outcome for someone who has sarcoidosis on the skin?
Although there is no cure for sarcoidosis, many people see their skin clear on its own without treatment.
Sarcoidosis can develop in other organs, such as the lungs, eyes, or liver. That’s why it’s so important to pay attention to your body. Finding sarcoidosis in other organs early and treating it can may prevent a more serious health problem.
To help patients with sarcoidosis prevent serious health problems, dermatologists recommend ongoing medical care when sarcoidosis is active. You’ll find the advice that dermatologists give their patients who have sarcoidosis at, Sarcoidosis and your skin: Tips for managing.
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References
Haimovic A, Sanchez M, et al. “Sarcoidosis: A comprehensive review and update for the dermatologist. Part II. Extracutaneous disease.” J Am Acad Dermatol 2012; 66:719.e1-10.