Sarcoidosos is a granulomatous disease with the potential to affect multiple organs. Although the cause remains unknown, several immune system abnormalities, such as reduced delayed-type hypersensitivity reactions, have been identified more commonly among patients with sarcoidosis than among individuals without the disorder. Sarcoidosis is 10 – 17 times more common in Blacks (36 to 64 new cases/100,000 population annually) compared with Whites (10 to 14 new cases/100,000 population annually) in the United States. Incidence is highest among Black women. The bimodal age peak for sarcoidosis is 25 to 35 years and 45 to 65 years of age. Sarcoidosis may affect any organ system, producing a wide variety of presenting symptoms. Symptoms may come on suddenly and disappear quickly as well, but they may also develop gradually over time, producing chronic problems. Many with sarcoidosis are asymptomatic, a lesion found accidently during x-ray evaluation for unrelated reasons. Approximately one-third of patients present with fever, fatigue, and weight loss. Most experience lung involvement with such common symptoms as dyspnea, dry cough, and chest tightness. Enlarged, moveable, nontender lymph nodes occur in one-third of patients. Other relatively common symptoms include anterior uveitis and cutaneous lesions, which appear in several forms: erythema nodosum, scar sarcoidosis, lupus pernio, papular, nodular and plaque forms.

Treatment varies depending on the organ system involved. Oral corticosteroids are often prescribed for patients with neurologic, cardiac, or ocular involvement as well as stage II or III pulmonary disease. Methotrexate, azathioprine, hydroxychloroquine, and anti-TNF agents may also be utilized to control the disease. Topical corticosteroids may be appropriate for limited skin lesions, but disfiguring, unresponsive lesions may require more aggressive therayp. Cyclosporine, chlorambucil, oral isotretinoin, allopurinol, minocycline, doxycycline, PUVA, anti-TNF agents, thalidomide, leflunomide, pentoxifylline, and melatonin have been used to treat skin symptoms.