Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Jan 31;16(1):e53290.
doi: 10.7759/cureus.53290. eCollection 2024 Jan.

Extra-pulmonary Cutaneous Sarcoidosis Presenting With Granulomatous Cranial Lesions and Cardiac Complications: A Case Report

Paul Q Vu  1 , Prutha R Pathak  2 , Siddharth Patel  3 , Ashish K Basu  4 , Mc Anto Antony  5 , Amogh D Reddy  1 , Jason Mathew  1
Affiliations
Case Reports

Extra-pulmonary Cutaneous Sarcoidosis Presenting With Granulomatous Cranial Lesions and Cardiac Complications: A Case Report

Paul Q Vu et al. Cureus. .

Abstract

Sarcoidosis is a non-caseating granulomatous disorder affecting multiple organs. Although the lungs are the most common site of presentation, extra-pulmonary manifestations involving the skin and heart can occur. Sarcoidosis affecting skull bone is uncommon and involvement of skin, heart, and skull bone all together, without pulmonary manifestations, is extremely rare. We report a 63-year-old Caucasian woman with a past history of cutaneous sarcoidosis and granulomatous skull bone lesions who presented with recurrent syncope. An ambulatory cardiac monitor detected intermittent high-grade atrioventricular block and cardiac MRI confirmed the diagnosis of cardiac sarcoidosis. This case represents an extremely unique journey of sarcoidosis and suggests potential consideration for cardiac sarcoidosis screening in patients with a history of extra-cardiac manifestations.

Keywords: complications of sarcoidosis; cutaneous sarcoidosis; extra-pulmonary manifestations; granulomatous disorder; granulomatous skull bone lesions; high-grade atrioventricular block; multisystemic sarcoidosis.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Event monitor (day 17) showing high-grade atrioventricular block
Figure 2
Figure 2. A 4.8 x 1.2 x 4.9 lesion involving left frontal skull bone and meninges of gadolinium enhancement on brain MRI (yellow arrow)
(A) T2-weighted-Fluid-Attenuated Inversion Recovery (T2-FLAIR). (B) T1-weighted-conventional spin echo (T1-SE)
Figure 3
Figure 3. Discoid, erythematous, non-itchy patch distal to the right elbow
Figure 4
Figure 4. Multifocal areas of late gadolinium enhancement on cardiac MRI (yellow arrows)
(A) Four-chamber view of post-contrast T1 images showing late gadolinium enhancement. (B) Short-axis view showing areas of late gadolinium enhancement
Figure 5
Figure 5. Overview diagrammatic representation of sarcoidosis
See this image and copyright information in PMC

References

    1. Clinical characteristics of patients in a case control study of sarcoidosis. Baughman RP, Teirstein AS, Judson MA, et al. Am J Respir Crit Care Med. 2001;164:1885–1889. - PubMed
    1. Biomarkers in the diagnosis and prognosis of sarcoidosis: current use and future prospects. Kraaijvanger R, Janssen Bonás M, Vorselaars AD, Veltkamp M. https://doi.org/10.3389/fimmu.2020.01443. Front Immunol. 2020;11:1443. - PMC - PubMed
    1. Epidemiology of sarcoidosis: current findings and future directions. Arkema EV, Cozier YC. Ther Adv Chronic Dis. 2018;9:227–240. - PMC - PubMed
    1. Sarcoidosis in America. Analysis based on health care use. Baughman RP, Field S, Costabel U, et al. https://doi.org/10.1513/annalsats.201511-760oc. Ann Am Thorac Soc. 2016;13:1244–1252. - PubMed
    1. Sarcoidosis--scientific progress and clinical challenges. Chen ES, Moller DR. Nat Rev Rheumatol. 2011;7:457–467. - PubMed

Publication types

LinkOut - more resources