Atypical Cutaneous Presentations of Sarcoidosis: Two Case Reports and Review of the Literature

  • David L. Leverenz
  • Christopher Henderson
  • Ankoor Shah
Autoimmunity (TK Tarrant, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Autoimmunity


Purpose of Review

The goal of this review is to provide the reader with an updated summary of the cutaneous manifestations of systemic sarcoidosis, with a particular emphasis on the predilection of sarcoidosis for scars, tattoos, and other areas of traumatized skin.

Recent Findings

While the mechanism underlying the propensity for traumatized skin to develop sarcoidosis lesions remains unclear, several theories have been proposed including the idea that cutaneous sarcoidosis represents an exuberant, antigen-driven foreign-body response, as well as the theory that traumatized skin represents an immunocompromised district with altered local immune trafficking and neural signaling.


In this review, we present two cases in which the development of cutaneous lesions in scars and tattoos was integral to the diagnosis of systemic sarcoidosis. We then review the various cutaneous manifestations of systemic sarcoidosis, the clinical characteristics and differential diagnosis of scar and tattoo sarcoidosis, the proposed mechanism by which traumatized skin is prone to developing sarcoidosis lesions, and current treatments for cutaneous sarcoidosis.


Cutaneous sarcoidosis Scar Tattoo Dermatology Rheumatology Allergy and immunology 



Erythema nodosum


Tumor necrosis factor


Compliance with Ethical Standards

Conflict of Interest

The authors declare no conflicts of interest relevant to this manuscript.

Informed Consent

Informed consent was obtained from all individual participants included in the study. Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance, •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • David L. Leverenz
    • 1
  • Christopher Henderson
    • 2
  • Ankoor Shah
    • 1
  1. 1.Department of Medicine, Division of Rheumatology and ImmunologyDuke University Medical CenterDurhamUSA
  2. 2.Department of DermatologyDuke University Medical CenterDurhamUSA

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