• Abnormal collection of inflammatory cells (granulomas) throughout the body.
    • Most common location for granulomas to occur are the lung, skin, heart, and brain.
    • Exact cause unknown - thought to be related to an immune reaction to a prior insult such as infection or chemical exposure earlier in life.
    • Do not confuse with infectious granulomatous processes such as tuberculosis.

Clinical Features

Sarcoidosis. (A) Subcutaneous nodules without changes in overlying epidermis. (B) Characteristic non-caseating granuloma with giant cell.
Lupus pernio is pathognomonic for sarcoidosis

Depend on location of granulomata. May be entirely asymptomatic.

Differential Diagnosis


Sarcoid Xray - hilar adenopathy
  • Definitive initial diagnosis unlikely to be made in ED, but may be suggested by typical granulomatous lesions seen on CT or other imaging in setting of appropriate clinical context
  • Evaluate for complications/alternative diagnoses of presenting symptoms



  • Dependent on presentation

See Also

External Links


  1. James WD, Berger TG, Elston DM. Macrophage/Monocyte Disorders. In: James WD, Berger TG, Elston DM (eds). Andrews’ Diseases of the Skin, 12e. Philadelphia, PA: Elsevier; 2016, Chapter 31.