Erythema nodosum

The erythema is an inflammation of the subcutaneous fatty tissue and occurs in the course of a hypersensitivity reaction. Besides sarcoidosis of the skin, erythema nodosum can be triggered by various autoimmune diseases and bacterial infections. Erythema nodosum is found on the face, arms, legs, trunk and mucous membranes.

The erythema is most frequently seen on the extensor sides of the lower legs. The skin inflammation is characterized by reddish, nodose areas. The nodules can have a size of 1 to 10 centimeters and turn bluish in the course of time. In most cases, spontaneous healing of the erythema occurs within a few weeks to months.

Therapy of sarcoidosis of the skin

Not every sarcoidosis requires treatment. 95% of acute sarcoidoses heal spontaneously within a few months, even without treatment. If the symptoms are severe, acute sarcoidosis of the skin can be treated with anti-inflammatory drugs such as acetylsalicylic acid (Aspirin®) or ibuprofen.

For more severe symptoms, cortisone is used. A chronic sarcoidosis of the skin is usually treated with cortisone over a period of several months. Very severe cases of sarcoidosis are treated with immunosuppressive drugs. Examples are the drugs methotrexate, azathioprine and chloroquine.

Duration vs. prognosis of sarcoidosis of the skin

The acute form of sarcoidosis heals spontaneously within months in 95% of patients. Fortunately, more than half of all sarcoidosis cases heal within two to five years. In about 10 to 30% of cases, the disease progresses progressively. Overall, the nodular skin changes heal better than the special form of lupus pernio. In sarcoidosis, the prognosis depends on the lung findings.

Causes of sarcoidosis of the skin

Sarcoidosis is an inflammatory multisystemic disease with no known cause. There is certainly an association with certain HLA antigens, which is why scientists assume a genetic predisposition for the development of sarcoidosis. At the same time, an association with environmental factors is also determining. These include work in the metalworking industry and work in agriculture.