Sarcoidosis is a systemic granulomatous disease characterized by the presence of non-caseating granulomas. Its etiology remains obscure. A plausible hypothesis suggests that a complex interplay of host factors, infectious processes, and non-infectious environmental factors, matched with a susceptible genetic background, results in a pathway that leads to systemic granulomatous inflammation. Although presentations of sarcoidosis vary enormously, multi-organ involvement is a common feature. Cutaneous involvement occurs in about 25% of patients with protean manifestations and variable prognoses. Skin manifestations are divided into specific lesions with histopathologically evident non-caseating granulomas and nonspecific lesions arising from a reactive process that does not form granulomas. A peculiar form of cutaneous sarcoidosis is represented by sarcoidal lesions at sites of trauma that has caused scarring. The pathogenesis of scar sarcoidosis remains unknown. Scar sarcoidosis is also associated with herpes zoster infection, surgery, and tattooing. Such heterogeneous events, along with those at the sites of chronic lymphedema, thermal burns, radiation dermatitis, and vaccinations, occur on areas of vulnerable skin labeled "immunocompromised districts". Numerous options are available for the treatment of cutaneous sarcoidosis. Although corticosteroids remain the treatment of choice for initial systemic therapy, other nonsteroidal agents have proven effective and therefore useful for long-term management. Tumor necrosis factor-α antagonists such as infliximab may have a role in the treatment of cutaneous sarcoidosis, especially in refractory cases that are resistant to standard regimens. Elucidation of the relationship of sarcoidal granulomas with malignancy and immunity may facilitate a better understanding of some pathomechanisms operating in neoplastic and immunity-related disorders.
This case series highlights the complexity of sarcoidosis-like reactions (SLRs) during cancer treatment, specifically in patients receiving immunotherapy or targeted therapies for melanoma. SLRs can either mimic disease progression or present as part of the clinical manifestation, making diagnosis and treatment challenging. Our study reviewed the medical records of 31 patients who were candidates for postoperative treatment between June 2022 and June 2024.
Department of Dermatology, Yale School of Medicine, 333 Cedar St, LMP 5040, PO Box 208059, New Haven, Connecticut, 06510, United States. Electronic address:
Sarcoidosis is a multisystem inflammatory disorder that most commonly affects the lungs, lymphatic system, eyes, and skin. Cutaneous involvement is present in approximately 20-30% of patients. Prednisone and corticotropin repositories are the only FDA-approved therapies for sarcoidosis.
- Diagnosing cardiac sarcoidosis (CS) is difficult, often leading to heart transplantation (HT) as the last option, especially when immunosuppressive therapies fail in advanced cases.
- The case study presents four patients, each with different symptoms and backgrounds, who ultimately required HT for their CS, revealing the condition's complexity and urgency.
- There are significant mid- and long-term challenges following HT for CS, notably the need for careful management of immunosuppression to prevent rejection and recurrence of sarcoidosis.
Sarcoidosis is a systemic granulomatous disease with variable ocular involvement. The most common ocular manifestation is uveitis, which can have potentially sight threatening complications such as glaucoma. We present the case of a man in his 30s with sarcoidosis and recurrent anterior uveitis, necessitating surgical intervention to control intraocular pressure and prevent further glaucomatous optic neuropathy progression.
