Sarcoidosis is often referred to as a masquerader or the ‘snowflake’ disease because patients present with so many different symptoms. The clinical picture can be complicated by intermittent inflammation in many different organs, making diagnosis difficult.
- Tender reddish bumps or patches on the skin
- Red and teary eyes or blurred vision
- Swollen and painful joints
- Enlarged and tender lymph glands in the neck, armpits and groin
- Enlarged lymph glands in the chest and around the lungs
- Nasal stuffiness and/or hoarse voice
- Pain in the hands, feet or other bony areas
- Kidney stone formation
- Enlarged liver (or spleen)
- Development of abnormal or missed heartbeats (arrhythmias), inflammation of the covering of the heart (pericarditis) or heart failure
- Nervous system effects, including hearing loss, meningitis, seizures or psychiatric disorders (for example, dementia, depression, psychosis)
- Calcium deposits in the kidneys, lungs, blood vessels, heart and other soft tissues
- High blood calcium levels
- Irregular heartbeat
- High blood pressure
- High cholesterol
Excess amounts of 1,25 Dihydroxyvitamin D3 can result in bone resorption.
Clinical impact of bone and calcium metabolism changes in sarcoidosis
Precipitation of hypercalcaemia in sarcoidosis by foreign sun holidays: report of four cases.
A case of severe hypercalcemia with acute renal failure in sarcoidosis: a diagnostic challenge for the emergency department.
Light sensitivity and dietary vitamin D sensitivity
Sarcoidosis can cause alveolitis, inflammation of the tiny sac-like lung air spaces where the exchange of carbon dioxide and oxygen take place. If the alveoli fill with fluid, there is less exchange of gases, which results in shortness of breath.
Clinical bronchiectasis complicating pulmonary sarcoidosis: case series of seven patients
- Papules (little bumps) resembling
- Granulomatous rosacea
- Benign appendageal tumors
- Skin tags
- Plaques resembling:
-Cutaneous T-cell lymphoma
- Lupus pernio resembling:
-Discoid lupus erythematosus
- Erythema nodosum resembling
-Other inflammatory panniculitis
”My experience with lupus pernio is that it flares with exposure to light plus cold and wind. Warning of the risk of scarring, whether on the skin or in the lungs, is a common tactic to pressure patients to use the treatment a physician prefers. Lupus pernio has a reputation for being difficult to treat. In reality, the doctor has no way to know whether a patient will scar. Certainly I sustained no scars from my winter bouts with lupus pernio.” Belinda Fenter
Sarcoidosis can cause oncholysis (loosening or lifting of the nail at the border).
See: Derm Net NZ (with photos)
Hair Loss - Alopecia Caused by Sarcoidosis
Red Plaques on forehead
Spots Darker than Flesh on the Face
Swollen eyelids (Lacrimal gland swelling)
Enlarged Lacrimal Gland
Sarcoid Lesion In Lining of Eyelid
Annular plaques on Face
Sarcoidosis on the nose - lupus pernio
Lupus Pernio in Sarc
Intranasal Inside the Nose
Corner of the Mouth
Inside Upper Lip
On the Tongue
Gingival Swelling Due to Sarcoidosis
Sarcoidosis on the back
Arms and hands
Sarcoidosis Lesions on the arm
Sarcoidosis on the elbow
Palmar erythema and hoarseness: an unusual clinical presentation of sarcoidosis
Red Lesions, Pimple-like
Legs and feet
Sarcoid Plaque on Knee
Coarse, scaly skin Acquired Icthyosis
Several photos of sarcoidosis skin lesions on a 7-year old
A collection of photos of sarcoidosis
Erythema Nodosum, papules, small nodules, raised plaques, lupus pernio and psoriasis-like lesions
Sino-nasal sarcoidosis: review and report of fifteen cases.
Facial Swelling and Systemic Sarcoidosis
Oral manifestations of sarcoidosis.
Granulomatous cheilitis (lip swelling) can lead to a sarcoidosis diagnosis
Sarcoidosis with maxillary involvement.
Affected salivary glands can produce too much saliva or (more commonly) too little saliva. Too little saliva when inflammation impairs or blocks the function of the salivary glands can result in gum disease and increased dental cavities.
Gingivitis Gingivitis is an inflammation of the gums and sarcoidosis is an inflammatory disease.
It’s not unusual for people with sarcoidosis to experience dysphagia (difficulty swallowing) as a symptom.
Patients may also experience dysphonia, trouble with the voice when trying to talk, including hoarseness and change in pitch or quality or voice.
Sarcoid inflammation of the eye, uveitis or treatment with prednisone can result in a cataract.
Uveitis is inflammation of the eye structure called the uvea. Other parts of the eye can also become inflamed, causing conditions such as scleritis or iritis. Researchers found cell-wall deficient bacteria in the vitreous fluid of patients with sarcoidosis. Complications of uveitis may include glaucoma, cataract, abnormal blood vessel growth, fluid within the retina and vision loss.
Scleritis associated with sarcoidosis.
Extensive abdominal lymphadenopathy in sarcoidosis.
Sarcoidosis of the liver
Patients may be told they have "fatty liver disease" or cirrhosis.
- Cranial nerve involvement
- Impaired taste and smell
- Blindness, blurry vision, double vision, visual field defects, pupillary abnormalities, dry and sore eyes
- Facial droop, slurred speech, impaired swallowing, hoarseness
- Vertigo, sensorineural deafness, tinnitus
- Weakness of trapezius and sternocleidomastoid muscles
- Tongue deviation and atrophy
- Meningeal involvement
- Headache is a prominent feature
- Aseptic meningitis (mononuclear pleocytosis with increased protein)
- Hydrocephalus (secondary to granuloma obstructing cerebral aqueduct)
- Intraparenchymal involvement
- Hypothalamus/pituitary disruption (electrolyte imbalance, changes in appetite, temperature, sleep and libido, diabetes insipidus, and syndrome of inappropriate secretion of antidiuretic hormone)
- Diffuse encephalopathy (delirium, psychiatric disorders, cognitive impairment)
- Seizure disorder (secondary to mass lesion, hydrocephalus, encephalitis, hypercalcemia)
- Spinal cord involvement
- Intra-, extramedullary; intra-, extradural process (myelopathy)
- Peripheral nerve involvement
- Mononeuropathy, mononeuropathy multiplex, polyneuropathy
- Sensory neuropathy - characterized by loss of sensation or abnormal sensation (eg, tingling, numbness, painful patches over the thorax)
- Motor neuropathy - characterized by weakness
- Muscle involvement
- Usually asymptomatic
- Symptomatic myopathy seen in less than 8 % of systemic sarcoidosis patients
- (May observe elevated creatine kinase)