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Case report
Sarcoidosis presenting as facial and scalp ulceration with secondary bacterial infection of the skin
  1. Georgi Fram,
  2. Smita Kohli,
  3. Angela Jiang and
  4. Scott Kaatz
  1. Henry Ford Hospital, Detroit, Michigan, USA
  1. Correspondence to Dr Georgi Fram; gfram1{at}


A 67-year-old man with a medical history of multiorgan sarcoidosis was admitted to the hospital with skin ulceration and a superimposed polymicrobial infection that had failed outpatient management. The patient’s outpatient regimen included doxycycline, ciprofloxacin and moderate-dose prednisone therapy for a coinfection with Pseudomonas aeruginosa and methicillin-susceptible Staphylococcus aureus. The patient presented after a syncopal episode initially thought to be due to severe dehydration. Owing to concern for cardiac sarcoidosis as well as worsening skin lesions, he was admitted to the hospital for cardiac monitoring and intravenous antibiotics. On admission, we broadened antibiotic coverage and initiated high-dose steroids at 1 mg/kg/day of prednisone. He was discharged on intravenous antibiotics and a slow steroid taper 3 days later. At the patient’s 1-month and 5-month follow-up clinic visits, he demonstrated remarkable improvement of his scalp and facial wounds.

  • dermatology
  • skin
  • medical management

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  • Contributors GF provided direct care for the patient while he was hospitalised and also contributed to the writing and editing of the manuscript. SKo and AJ both provided direct care for the patient and contributed to the writing and editing of the manuscript. SKa contributed to the writing and editing of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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