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Number 2 Medical Dermatology
(Chronic & Inflammatory Skin Diseases)

Number 1 Skin Cancer & Pre-Cancer Care
Number 1 Medical Dermatology
(Chronic & Inflammatory Skin Diseases)
Number 3 Pigment & Lesion Disorders
Number 4 Non-Cancer Growth
Number 5 Surgical Dermatology (Non-Cancer Procedures)
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Sarcoidosis (Skin Involvement) PDF

• Sarcoidosis (Skin Involvement)

(An inflammatory condition that can affect the skin and other organs)

1. What Is Sarcoidosis?

Sarcoidosis is an inflammatory condition in which the immune system forms small clusters of inflammatory cells, called granulomas, in different parts of the body. It can affect many organs—most commonly the lungs and lymph nodes—and it can also involve the skin.

Sarcoidosis is not contagious and not caused by infection. Its course varies widely: some people have mild disease that improves on its own, while others need ongoing treatment.

How Sarcoidosis Affects the Skin

Skin involvement (called cutaneous sarcoidosis) may be the first sign of sarcoidosis—or occur in people who already have a diagnosis.

Skin findings can include:

  • Firm bumps or plaques (skin-colored, red-brown, or purple)

  • Lesions on the face, neck, arms, or legs

  • Lupus pernio: violaceous thickening on the nose, cheeks, lips, or ears

  • Scars or tattoos that become raised or inflamed

  • Areas that don’t itch much but feel firm or tender

Because sarcoidosis skin lesions can look like many other conditions, evaluation by a dermatologist is important.

Other Symptoms to Mention

Even if you’re seeing us for skin changes, tell us if you also have:

  • Shortness of breath or persistent cough

  • Fatigue or unexplained weight loss

  • Joint pain or swelling

  • Eye irritation or vision changes

  • Enlarged lymph nodes

These details help guide testing and coordination of care.

How We Diagnose Sarcoidosis

Diagnosis often involves several steps:

1. Skin Examination

We look at lesion type, location, color, and firmness.

2. Skin Biopsy (Key Step)

A small sample of skin is removed and examined under the microscope. Sarcoidosis typically shows noncaseating granulomas.
This helps confirm the diagnosis and rule out look-alike conditions.

3. Additional Testing (When Needed)

If sarcoidosis is confirmed or suspected, we may coordinate:

  • Blood tests

  • Imaging (such as chest imaging)

  • Referrals to pulmonology, rheumatology, or ophthalmology

Treatment Options

Treatment depends on:

  • Severity of skin involvement

  • Symptoms

  • Whether other organs are affected

Skin-Directed Treatment

For limited skin disease:

  • Prescription topical medications to reduce inflammation

  • Local treatments for symptomatic or cosmetically sensitive areas

Systemic Treatment

If skin disease is extensive or other organs are involved:

  • Oral or injectable medications that calm the immune system

  • Coordinated care with other specialists

Some skin lesions may improve slowly—even with treatment—so patience and follow-up are important.

Pre-Op Instructions

(Not surgery—these are “before your visit or biopsy” tips)

Before Your Appointment

  • Take photos of skin lesions if they change or fade between visits

  • Bring a list of:

    • All medications and supplements

    • Any prior sarcoidosis testing or diagnoses

  • Note any systemic symptoms (lungs, eyes, joints, fatigue)
If a Skin Biopsy Is Planned

  • Tell us if you:

    • Take blood thinners

    • Bruise easily

    • Have allergies to numbing medicine, antiseptics, or adhesives

⚠️ Do not stop prescribed blood thinners unless directed by your prescribing clinician.

Post-Op Instructions

After a Skin Biopsy

  • Keep the bandage on and dry for 24 hours (unless told otherwise)

  • After 24 hours, daily:

    1. Clean gently with soap and water

    2. Pat dry

    3. Apply a thin layer of ointment if instructed

    4. Cover with a clean bandage

  • Avoid soaking (baths, pools, hot tubs) until healed

  • Call if you notice increasing redness, warmth, swelling, pus, fever, or bleeding that won’t stop with pressure

After Starting Treatment

  • Use medications exactly as prescribed

  • Improvement may take weeks to months

  • Keep follow-up appointments so we can adjust your plan as needed

When to Seek Urgent Care

Seek urgent or emergency care if you develop:

  • Worsening shortness of breath or chest pain

  • Vision changes or severe eye pain

  • Neurologic symptoms (weakness, numbness, severe headache)

  • Rapidly worsening skin pain or blistering

Frequently Asked Questions

Is sarcoidosis contagious?

No. Sarcoidosis is not contagious.

No. While some people have skin-limited disease, sarcoidosis can also affect the lungs, lymph nodes, eyes, joints, heart, or nervous system. That’s why coordination of care is important.

It’s considered an immune-mediated inflammatory condition. The exact cause is unknown.

Many rashes look similar. A biopsy helps confirm sarcoidosis and rule out infections or other inflammatory conditions that require different treatment.

In some people, sarcoidosis improves or resolves over time. In others, it may be chronic and need ongoing management. The course is highly individual.

Sun sensitivity varies. Some skin lesions may darken or become more noticeable with sun exposure. We’ll advise you on sun protection based on your presentation.

Some skin lesions may resolve without scarring, while others—especially thicker plaques—can leave texture or color changes.

Follow-up depends on severity and whether other organs are involved. Your dermatologist will recommend an appropriate schedule.