title: Specific cutaneous lesions in patients with systemic sarcoidosis: relationship to severity and chronicity of disease.
abstract: BACKGROUND
  Specific (granulomatous) cutaneous lesions are seen in 9-37% of cases of systemic sarcoidosis, and are usually classified into maculopapules, plaques, lupus pernio (LP), scar sarcoidosis, and subcutaneous sarcoidosis. Their prognostic significance has not been fully established.
  
  
  OBJECTIVE
  To analyse the relationship between the clinical type of granulomatous cutaneous lesions and the systemic features and prognosis of systemic sarcoidosis.
  
  
  METHODS
  The clinical charts of 86 patients (19 men, 67 women, mean age 46.82 years) with systemic sarcoidosis and granulomatous cutaneous involvement followed up for > 2 years at Bellvitge University Hospital were reviewed.
  
  
  RESULTS
  Cutaneous lesions developed before or at the time of diagnosis of systemic sarcoidosis in 80.23% of patients. The main cutaneous lesions were classified as maculopapules (28 patients), plaques (31), LP (6), scar sarcoidosis (7) and subcutaneous sarcoidosis (14). Erythema nodosum (EN) was seen in 30 patients. Radiological stage was 0 for 8 patients, I for 48, II for 24, III for 5 and IV for 1. Systemic sarcoidosis activity persisted for > 2 years in 47 patients, and 42 received systemic corticosteroid treatment for their disease. Maculopapular and subcutaneous sarcoidosis were mainly seen in patients with EN and radiological stage I. Plaques and LP were associated with chronic disease and requirement for systemic corticosteroids.
  
  
  CONCLUSIONS
  Cutaneous granulomatous lesions are usually present at the diagnosis of systemic sarcoidosis, and the type of cutaneous involvement may have prognostic significance.
authors.affiliation: Department of Dermatology, Bellvitge University Hospital, IDIBELL, University of Barcelona, Barcelona, Spain. jmarcoval@bellvitgehospital.cat
authors.forename: J
authors.initials: J
authors.lastname: Marcoval
authors.forename: J
authors.initials: J
authors.lastname: Mañá
authors.forename: M
authors.initials: M
authors.lastname: Rubio
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006099:Granuloma / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012507:Sarcoidosis / Q000188:drug therapy / Q000473:pathology*; D012720:Severity of Illness Index; D012871:Skin Diseases / Q000473:pathology*; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones