Sarcoidosis can cause changes to the skin, including bumps, nodules, discoloration and rashes. Knowing the signs of sarcoidosis can help you understand when it may be time to see a dermatologist.
What Is Sarcoidosis?
When unexplained skin changes appear, it can be difficult to know what is causing them. Sarcoidosis is one possible cause. It is an inflammatory condition in which the immune system forms small clusters of inflamed tissue called granulomas.
Granulomas can develop in almost any part of the body. The lungs and lymph nodes are most commonly affected, but sarcoidosis can also affect the skin, eyes, heart and nervous system.
- Fever
- Fatigue
- Swollen lymph nodes
- Weight loss
- Joint pain and swelling
- Persistent cough
- Shortness of breath
- Eye irritation
When granulomas form in the skin, the condition is called cutaneous sarcoidosis. Skin changes can take several forms and may occur with or without involvement of internal organs. Because they can look like other skin conditions, an evaluation by a dermatologist can help identify the cause.
Skin Symptoms of Sarcoidosis
Sarcoidosis can cause several types of skin changes. Some are direct skin lesions that contain the granulomas associated with sarcoidosis. These may appear as small bumps, raised plaques or nodules that are skin-colored, red, reddish-brown or purplish.
These lesions can develop on the face, neck, arms or other areas of the skin.
Sarcoidosis can also cause indirect skin findings that do not contain granulomas. One example is erythema nodosum, which causes tender, red nodules, usually on the shins. These skin changes can sometimes be an early sign of sarcoidosis.
Because these symptoms can resemble other skin conditions, including granuloma annulare, a board-certified dermatologist can help determine the cause. A skin examination may also help identify findings that warrant evaluation for sarcoidosis beyond the skin.
Lupus Pernio
Lupus pernio causes bluish-red, purple or reddish bumps and nodules, most often on the nose, cheeks and ears. It is a characteristic skin finding associated with sarcoidosis and may be associated with more chronic disease.
Lupus pernio can resemble conditions such as acne or rosacea, but these conditions require different treatments. If persistent bumps or discoloration on the face do not respond to typical treatments, a dermatologist can help determine the cause.
Sarcoidosis In Scars, Tattoos & Piercings
Sarcoidosis can sometimes develop in areas of previous skin injury. An old scar, tattoo or piercing may become raised, red, swollen or tender. These changes can occur even when the original injury happened years earlier.
Changes in previously healed areas of skin can be an important clue when diagnosing cutaneous sarcoidosis. Your dermatologist may recommend a biopsy to determine whether sarcoidosis is causing the changes.
Causes & Risk Factors
The exact cause of sarcoidosis is unknown. Genetics and environmental factors are thought to play a role in how the condition develops.
Sarcoidosis can affect people of any age, but it most often develops in adults. It is more common in people of African descent and people of Scandinavian descent, and women are affected more often than men.
Having one or more risk factors does not mean you will develop sarcoidosis. Researchers are still studying why the immune system responds this way in some people.
Diagnosing Sarcoidosis
Because sarcoidosis can look like other skin conditions, finding the cause may require more than a visual examination. Your dermatologist will examine your skin and ask about your symptoms, medical history and overall health.
A skin biopsy is often used when cutaneous sarcoidosis is suspected. During a biopsy, your dermatologist removes a small sample of affected skin so it can be examined under a microscope. The results can help identify granulomas and rule out other conditions with similar findings.
If sarcoidosis is suspected, your care team may also recommend additional testing to determine whether other parts of the body are affected.
Once a diagnosis is confirmed, treatment can be tailored to your symptoms and overall health.
Treatment at Goodskin Dermatology
Treatment for cutaneous sarcoidosis depends on the type, location and extent of your skin symptoms. Your dermatologist will consider your individual needs when recommending treatment.
Treatment options may include:
- Topical medications: Corticosteroid creams or ointments may help manage localized skin lesions
- Intralesional steroid injections: A corticosteroid can be injected directly into individual lesions to reduce inflammation
- Systemic medications: More widespread or difficult-to-treat sarcoidosis may require medications such as hydroxychloroquine, methotrexate or azathioprine
Because sarcoidosis can also affect internal organs, treatment may involve other medical specialists when needed. Your dermatologist can help coordinate care when systemic involvement is suspected or already diagnosed.
At Goodskin Dermatology, our board-certified dermatologists take the time to understand your symptoms and develop a treatment approach based on your condition.
Learn more about our providers and their approach to dermatologic care.
Frequently Asked Questions
Is Sarcoidosis Contagious?
No. Sarcoidosis is an inflammatory condition related to the immune system. It is not caused by a contagious infection, so it cannot spread from person to person.
Can Sarcoidosis Go Away on Its Own?
Yes. In some people, sarcoidosis improves or resolves without treatment. Others may have symptoms that persist or return and require ongoing care. Because sarcoidosis can affect internal organs, an evaluation can help determine whether monitoring or treatment is appropriate.
What Organs Does Sarcoidosis Affect Besides the Skin?
Sarcoidosis most commonly affects the lungs and lymph nodes, but it can also affect the eyes, heart, liver and nervous system. Granulomas can form in many tissues throughout the body. If your dermatologist suspects involvement beyond the skin, additional evaluation may be recommended.
Schedule a Skin Evaluation
Unexplained skin changes can leave you with questions about what is causing them and whether they need treatment. A careful evaluation can provide answers and help determine the next step.
The board-certified dermatologists at Goodskin Dermatology can evaluate your skin and help determine whether sarcoidosis or another skin condition is responsible. If you are due for a full-body skin evaluation our dermatology team can help you understand what your skin needs.
Goodskin Dermatology has offices in Clackamas, Troutdale, Beaverton and Hillsboro.
