Subcutaneous sarcoidosis: A clinical analysis of nine patients

Background Subcutaneous sarcoidosis is the only specific subset of cutaneous sarcoidosis frequently associated with systemic disease. Conversely, the disease activity, severity and prognosis have not yet been elucidated due to the limited number of reported cases. Objectives The purpose of this study was to identify the clinical, laboratory and prognostic differences between subcutaneous sarcoidosis and other types of cutaneous sarcoidosis. Methods All patients with sarcoidosis histopathologically diagnosed from 2000 to 2012 at our institution were enrolled. The clinical, laboratory, chest X-ray and pulmonary function test results were retrospectively evaluated in the patients with cutaneous sarcoidosis. Results In the 130 patients with sarcoidosis, cutaneous sarcoidosis was diagnosed in 37 patients (28.4%) in which at least 9 (6.9%) patients had subcutaneous sarcoidosis. The serum levels of soluble intereukin-2 receptor (sIL-2R) were significantly elevated in the group of patients with subcutaneous sarcoidosis in comparison to the patients with other types of cutaneous sarcoidosis, whereas there was no difference in the severity score between the two groups. Following a 2-years-observation period, three patients were in remission, six patients demonstrated persistent disease and one patient had progressive disease. Conclusion Subcutaneous sarcoidosis may be associated with the disease activity, although it was not found to be associated with the disease severity and it was not a predictive factor for the prognosis. Furthermore, the frequency of subcutaneous sarcoidosis in the present study may be higher than that in previous reported series.