A change in a scar, tattoo or other skin lesion may be a manifestation of sarcoidosis.


Lesions that may be affected:

(1) scar

(2) tattoo

(3) venipuncture site

(4) injection site

(5) site of blunt trauma


The lesions may appear:

(1) erythematous or purple

(2) swollen

(3) tender and/or painful

(4) rarely ulcerated


Biopsy of the lesion will show noncaseating granulomas that are negative for acid fast bacilli, fungi and polarizable material.


The patient may have a history of sarcoidosis, or the skin changes may coincide with the initial presentation.


Other manifestations of sarcoidosis may or may not be present:

(1) bilateral hilar adenopathy

(2) pulmonary lesions and/or change in pulmonary function

(3) organ involvement (cardiac, neurologic, etc.)

(4) elevated serum angiotensin converting enzyme (ACE)

(5) elevated serum lysozyme

(6) hypercalcemia


Differential diagnosis:

(1) foreign body granuloma, including suture granuloma

(2) deep fungal or mycobacterial infection

(3) hypertrophic scar or keloid


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