Cutaneous sarcoidosis associated with sarcoidosis of the upper airway

Abstract

The diagnosis of laryngeal sarcoidosis is frequently delayed because it is rare and often develops insidiously. A 24-year-old woman with the annular scarring form of cutaneous sarcoidosis later contracted laryngeal sarcoidosis. Despite a two-year history of upper respiratory tract symptoms, the patient's progressive respiratory distress was attributed to sarcoidal pulmonary involvement. Dermatologists should be aware of the risk of airway obstruction from laryngeal granulomas in patients with cutaneous sarcoidosis. Although most commonly associated with the lupus pernio form of sarcoidosis, upper airway granulomas also develop in patients with other cutaneous manifestations of sarcoidosis.

Sarcoidosis

“…Lupus pernio lesions not only can ulcerate and scar but may infiltrate the upper respiratory tract and cause nasal ulceration, septal perforation, and obstruction. 61,78 Less commonly, lupus pernio develops on the dorsal hands, fingers, and toes where it is associated with bone cysts, dystrophic nails, and lytic bone lesions, 2,52 but some cases with exclusive involvement in these have been chilblains pernio. The eruption can be recalcitrant to even aggressive systemic treatment.…”

Polypoid type of laryngeal sarcoidosis - case report and review of the literature

“…The primary symptoms of laryngeal sarcoidosis are dysphonia and dyspnea [2,10,13], and the symptoms are caused by airway obstruction. Thus, in cases that do not resolve spontaneously, treatment for laryngeal sarcoidosis should be performed to remove obstruction in the airway.…”

Mutilating Facial Sarcoidosis

“…Lupus pernio describes a form of sarcoidosis with violaceous plaques on the central face [1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11]. It was first described by Ernest Besnier in 1889 [12].…”

“…It should be emphasized that nodular and atypical forms of sarcoidosis are more frequent in black people, sometimes with a tendency towards ulceration or mutilation [3, 7, 8, 9, 15]. Women and blacks have been characterized as twice as likely as men and whites to have ulcerative sarcoidosis [20], although necrobiotic-like and other atypical forms occur in whites too [21].…”

“…It is a violaceous, indurated plaque that is characteristically located on the nose, ears, lips and other areas of the face. Typically seen in women, lupus pernio is associated with chronic, persistent sarcoidosis that has a predilection for upper respiratory involvement [1, 2, 3, 4, 5, 6, 7, 8, 9, 10]. However, frank cutaneous tumors are rarely seen in lupus pernio.…”