PT  - JOURNAL ARTICLE
AU  - Izadi Firouzabadi, Leila
AU  - Ghanadan, Alireza
AU  - Fahim, Shabnam
AU  - Sadeghinia, Ali
TI  - Multiple firm nodules in a young woman: an unusual presentation of sarcoidosis
AID  - 10.1136/bcr-2020-237264
DP  - 2021 Jan 01
TA  - BMJ Case Reports
PG  - e237264
VI  - 14
IP  - 1
4099  - http://casereports.bmj.com/content/14/1/e237264.short
4100  - http://casereports.bmj.com/content/14/1/e237264.full
SO  - BMJ Case Reports2021 Jan 01; 14
AB  - A 27-year-old woman presented to the dermatology department with a 1-year history of multiple asymptomatic violaceous lesions on her upper and lower extremities, trunk and abdomen. The lesions were firm on palpation. She had no other associated symptoms and the rest of the examination was unremarkable. An incisional biopsy showed multiple confluent granulomas composed of histiocytes devoid of necrosis surrounded by a rim of lymphocytes extending to the subcutaneous fat consistent with the diagnosis of subcutaneous sarcoidosis. The serum ACE assay was elevated at 134 IU/L. Other blood tests including complete blood count, renal and liver function tests, serum calcium and phosphate were within normal ranges and chest X-ray was unremarkable. Complete remission was achieved with an intralesional triamcinolone injection (10 mg/mL) for a few sessions. Subcutaneous sarcoidosis is a rare variation and its diagnosis requires a high index of suspicion.