By Gary M. White, MD
Lupus pernio is a subtype of sarcoidosis where the central face--especially the nose and prominences of the cheeks--are affected. Lesions on other acral areas may occur.
- This variant of sarcoidosis is more commonly associated with chronic persistent disease, pulmonary fibrosis, bone lesions, and involvement of the nose and upper respiratory tract.
- In one study of 35 patients [Lupus 1992;1;129], 74% had intrathoracic sarcoidosis, 54% had upper respiratory involvement, 54% had reticulo-endothelial involvement, 43% had bone cysts and 37% had ocular lesions.
Red, smooth papules and plaques on the nose and other acral areas, such as the ears, fingers and toes occur. Very large nodules may rarely develop [Dermatology 1999;199;265-267].
The standard systemic therapies for sarcoidosis would of course be helpful. A medium to high potency topical steroid with close follow up may be tried. Intralesional triamcinolone, e.g. 5 mg/cc monthly times 3 can be done. The CO2 laser may debulk nicely. Standard surgical excision may be performed for large lesions.
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