Objective: To assess the presence of foreign material in the granulomatous
cutaneous lesions of patients with systemic sarcoidosis.
Design end getting: Observational study reevaluating histological specimens
at a university referral hospital.
Patients: Sixty-five patients diagnosed as having sarcoidosis who developed
granulomatous cutaneous involvement.
Main Outcome Measures: To detect the presence of polarizable foreign partic
les in cutaneous biopsy specimens and to evaluate the association with clin
ical features of the patients.
Results: Granulomatous cutaneous involvement was demonstrated in 65 (15.3%)
of 425 patients with systemic sarcoidosis. In 14 (22%) of the 65 patients,
the cutaneous biopsy specimen showed foreign particles in polarized light.
The skin lesions corresponded to 3 different clinical patterns: an admixtu
re of papules and infiltration of previously undetected minute scars (n=6):
scar sarcoidosis (n=4), and subcutaneous nodules (n=4). The lesions were l
ocated most frequently in the extremities, involving the knees in 10 patien
ts.
Conclusions: The presence of polarizable foreign body material in granuloma
tous cutaneous lesions is not infrequent in patients with systemic sarcoido
sis. Inoculation of foreign matter from a previous inapparent minor trauma
may induce granuloma formation in individuals with sarcoidosis.