A Case of Interstitial Cutaneous Sarcoidosis

Abstract

A 57-year old African American woman with pulmonary sarcoidosis presented to the emergency room with a large solitary violaceous plaque on her right lower leg. The lesion, initially diagnosed as cellulitis, was ultimately confirmed to be interstitial cutaneous sarcoidosis. Classically sarcoidosis is characterized histologically by noncaseating granulomas with a paucity of inflammatory cells (“naked granulomas”); however in 16 – 20% of cases, an interstitial histocytic pattern is noted under the microscope. Various treatment regimes have been described for cutaneous sarcoidosis, including the use of tetracycline and its derivatives. The patient described here was treated with oral minocin and topical dermovate ointment, with significant improvement in the appearance and symptomatology of the lesion.