Cutaneous sarcoidosis with cardiac involvement

Despite the clinical importance of cardiac involvement in the prognosis of sarcoidosis. it is often overlooked because of the subclinical disease prog ression and difficulty in diagnosis. We report here five patients with cuta neous sarcoidosis lesions where cardiac involvement was detected with the a ppearance of mild cardiac symptoms on a careful examination of the heart af ter cutaneous sarcoidosis was diagnosed. In four of the five cases, the pat ients had annular lesions while the fifth case showed a nodular eruption on the face, Three of the five patients showed complete AV block while one sh owed complete right bundle block and left bundle anterior branch block. All four patients with conduction disturbances underwent a permanent pacemaker implantation with prednisolone tapering therapy. The remaining patient had congestive heart failure and was treated with prednisolone alone. The pres ent findings support the belief that sarcoidosis patients with cutaneous le sions, especially facial annular lesions, should be carefully examined and monitored for cardiac involvement, oven in cases without apparent cardiac s ymptoms.