Sarcoidosis of the skin occurs in 20 to 35% of all sarcoidosis patients. Sometimes a skin condition may be the only complaint. There are several types of skin disorders that can occur with sarcoidosis including erythema nodosum, lupus pernio and brownish-red lumps and bumps (lesions).
Lupus pernio is a chronic condition; it rarely disappears spontaneously and can cause permanent damage to the skin where it occurs. Proper and timely medication for this skin condition is very important.
Other Skin Lesions
The skin may produce thick bumps (nodules) and smaller bumps of a few millimeters in diameter (papules). In some cases, these bulges sit so close together that they form a sort of plate, also called plaque. These lesions most commonly occur on the extremities, face, scalp, back, and buttocks. They are usually reddish-brown in colour and are not usually symptomatic. These lesions most commonly occur on the extremities: face, scalp, back, and buttocks.
Skin disorders during sarcoidosis are often spontaneous and pose no threat to general health. Therefore, full recovery is seen in many cases. However sometimes the skin is so damaged, painful or disfiguring that the patient may feel very physically or socially uncomfortable. Skin lesions take time to recover. In these cases, the dermatologist may prescribe the following medications:
Ointments or creams contain corticosteroids which suppress the inflammation of the skin. However, corticosteroids can make the skin thin and fragile in the long term.
皮質類固醇片 (e.g. prednisolone) may be prescribed for severely disfiguring disorders and conditions that do not heal spontaneously. The treatment with these drugs usually takes a number of months. Prescriptions will only be given in the most serious of cases due to adverse side effects of corticosteroids.
Hydroxychloroquine/Mepacrine These medicines were originally used in the treatment of malaria. Dermatologists may prescribe these drugs to treat various forms of skin sarcoidosis.
免疫抑製藥物 inhibit cell division and are only prescribed if corticosteroids do not provide sufficient recovery. Methotrexate is an example of such a medication. Although your GP may be able to provide ongoing prescriptions, these medications should be supervised by a consultant dermatologist.
Sarcoidosis and Tattoos
There is a reported risk that sarcoidosis can be triggered, or existing symptoms worsened, by tattoos. A flare up is indicated by nodules appearing on the tattoo. Some patients have actually been diagnosed with sarcoidosis due to their tattoos suddenly producing raised scars. Some colours are more likely to cause problems than others.
The interaction between sarcoidosis symptoms and tattoos may be caused by either the tattoo procedure breaking the skin or the tattoo ink itself. Not all patients are affected – some may not experience any symptoms, particularly if they do not have skin sarcoidosis.
SarcoidosisUK therefore recommends that patients with sarcoidosis do not get tattoos, particularly those patients with existing skin sarcoidosis. If you are concerned about existing tattoos or would like to discuss your options, contact the 結節病英國護士幫助熱線 or your GP.
閱讀更多: Tattoo Sarcoidosis (Lyons, A., Brayman, G. & Tahhan, S. J GEN INTERN MED (2018) 33: 128.)
Page last updated: July 2019. Next review: July 2021.