Sarcoidosis and the Skin
Skin lesions, or granulomas that develop on the skin, occur in about 25 percent of cases of sarcoidosis. Most skin lesions are harmless, although they can cause scarring and disfigurement. One type, lupus pernio, develops on the face and can leave scars. Another type, erythrema nodosum, develops on the legs and is quite painful.
Erythrema nodosum lesions are small, hard nodules that develop on the lower parts of the leg and usually disappear without treatment. The bumps appear rather suddenly and are tender and painful. Sometimes, they are accompanied by a mild fever and arthritis in the ankle and other joints.
Although a common symptom of sarcoidosis, the occurrence of erythrema nodosum does not necessarily mean that a person has sarcoidosis. Other causes of erythrema nodosum include infections and drug sensitivity.
Lupus Pernio & Sarcoidosis
Lupus pernio is a chronic (long term), persistent skin lesion that forms on the face, especially the nose, ears, and cheek. It can leave permanent scarring and nasal disfigurement. It may also affect the hands and feet.
Gastrointestinal Disturbances & Sarcoidosis
Patients with sarcoidosis may experience dysphagia (difficulty swallowing), abdominal pain, or jaundice (a yellowing of the skin that can be caused by any number of underlying disorders).
Spleen & Sarcoidosis
The spleen is an organ in the upper abdominal cavity that plays an important role in storing red blood cells, as well as filtering out old red blood cells from the circulating blood supply. Although usually asymptomatic, sarcoidosis granulomas are often scattered throughout the spleen.
Liver & Sarcoidosis
Up to three-fourths of patients develop granulomas in the liver that rarely create symptoms. Granulomas in the liver can also be due to cirrhosis, tuberculosis, and Hodgkin's disease.
Neurological Symptoms of Sarcoidosis
Sarcoidosis can affect any part of the nervous system. Not more than about 5 percent of sarcoidosis patients have neurological manifestation. Symptoms can range from short-lived facial nerve palsy (e.g., Bell's palsy), to chronic visual or hearing problems, to symptoms that mimic a tumor.
Patients may experience headache, paresthesia (an abnormal prickly or tingling sensation), seizures, or meningitis (inflammation of the brain or spinal cord). Granuloma involvement in the hypothalmus can lead to diabetes insipidus. Sarcoidosis can also lead to obstructive hydrocephalus.
Cardiac Symptoms of Sarcoidosis
It is estimated that about 20 to 25 percent of patients with sarcoidosis have cardiac granulomas. Like many other organs, sarcoidosis granulomas on the heart are usually asymptomatic. Heart problems can arise, however, usually as secondary complications due to granulomas in the lung.
Cardiac symptoms may include syncope (temporary loss of consciousness due to inadequate blood flow to the brain), congestive heart failure (CHF; the inability of the heart to adequately pump blood throughout the body causing a back up of fluid into the lungs), cardiac tamponade (compression of the heart due to an accumulation of fluid in the pericardium, the membrane that covers the heart), or dyspnea (difficult breathing). At its worst, sudden cardiac arrest can occur.
Sarcoidosis & Bones, Joints, and Muscles
Bones, joints, and muscles can be affected by sarcoidosis. The bones are rarely affected and when they are, it is usually in conjunction with lupus pernio. The bones in the hands, feet, and nose may be affected and the joints in the hands and feet may swell. A patient who has swollen lymph nodes and erythema nodosum may experience pain and tenderness in the muscles that is usually a short-lived myopathic problem (myopathy) that resolves on its own.
Kidneys & Sarcoidosis
Asymptomatic granulomas invade the kidneys as often as they do the lungs and liver and very rarely do complications result. Nephrolithiasis (the formation of a kidney stone that can cause abdominal pain and blood in the urine) could occur. In severe cases, kidney failure can result.
Sarcoidosis & General Ill Feelings
Some patients may experience fever, malaise, fatigue, and weight loss.