Subcutaneous sarcoidosis: report of two cases and review of the literature

Sarcoidosis is a multisystemic disease with cutaneous lesions present in about one fourth of patients. Cutaneous lesions may be specific or nonspecific based on the presence or the absence of sarcoidal granulomas. Subcutaneos sarcoidosis is the less frequent of the specific cutaneous lesions of sarcoidosis. We report here 2 new cases and review 83 cases reported in literature of subcutaneous sarcoidosis. Subcutaneous sarcoidosis present usually with asymptomatic firm nodules covered by normal-appearing skin, mostly on the forearms and legs. Diagnosis may require a high index of suspicion. In the vast majority of patients, subcutaneous nodules were the manifestation that allowed the diagnosis of systemic sarcoidosis. There is a strong association between subcutaneous sarcoidosis and bilateral hilar lymphadenopathy (72.7%). About 15% of patients have in order of frequency uveitis, parotitis, arthritis, mucositis, dactylitis, neurological and renal involvement, hepatosplenomegaly.