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Cutaneous sarcoidosis: clinical features and management.

Of 145 patients with clinical and histologic evidence of sarcoidosis, 41 (28 percent) presented with various cutaneous manifestations of the disease. The skin lesions have included erythema nodosum in 14 patients, lupus pernio in 6, skin plaques in 9, maculopapular eruptions in 10, and scars in 2 patients. Two patients with erythema nodosum had subcutaneous nodules. Erythema nodosum was accompanied by early reversible bilateral hilar adenopathy in 64 percent of patients. X-ray abnormality cleared in 79 percent of patients. Lupus pernio and skin plaques were associated with a chronic persistent course. Radiologic clearing of the lungs occurred in 22 percent of patients with skin plaques and in none of the patients with lupus pernio. Ocular and bone lesions were seen more often in patients with chronic skin lesions, whereas peripheral lymphadenopathy was frequent in patients with maculopapular rash. Skin lesions do not constitute an absolute indication for therapy. Unsightly lesions may be corrected by oral and topical corticosteroid therapy. Chloroquine has been proved to be effective in selected instances of chronic cutaneous sarcoidosis.