SARCOIDOSIS SHOWING A LIVEDO RETICULARIS-LIKE ERUPTION

We report a case of sarcoidosis in a 22-year-old man. A month before t he first visit, mistiness in the left eye had developed and an eruptio n on the lower legs had appeared. The eruption then enlarged and coale sced. Chest X-ray examination revealed bilateral, hilar lymphadenopath y (BHL). Iritis was also present. His mother had been diagnosed as suf fering from sarcoidosis. On examination, there were many nail-sized, e rythematous areas on both lower legs, partly showing a reticular appea rance because of coalescence, leaving islands of normal skin on some a reas. Slight induration was felt. A biopsy specimen showed relatively small nodules scattered from the dermis to the subcutaneous fat, mainl y around the sweat glands or vessels and partly containing giant cells , with no caseation necrosis. Serum angiotensin converting enzyme (ACE ) level was 24.8 IU/l. The serum calcium level was within normal limit s. The skin test reaction to the purified protein derivative of tuberc ulin was 0 x 0/7 x 7. Treatment with oral prednisolone at 20 mg/day an d topical betamethasone valerate was instigated and the eruption disap peared within a week.