The Risk of Pulmonary and Ocular Involvement in Patients Presenting with Cutaneous Sarcoidosis of the Face/Head: A Retrospective Study

Sarcoidosis, an idiopathic granulomatous disease, predominantly affects the lungs, eyes, and skin.1 In addition, However, it is uncertain whether the presence of skin lesions on the head is a risk factor for impending pulmonary and ocular involvement, which could inform healthcare providers. To begin to address this issue, we determined the relative risk (RR) of patients presenting with cutaneous sarcoidosis (CS) of the head that later developed pulmonary and ocular sarcoidosis. The electronic medical records of 51 patients diagnosed with biopsy-proven CS at the University of Illinois Bernie Mac STAR Center between January 1, 2012, to April 30, 2022, were reviewed. Pertinent demographic, clinical, and medical imaging information were abstracted in each case. The RR of patients with CS of the head harbingering pulmonary and ocular involvement was compared to those with lesions sparing the head. The cohort was composed of predominantly black patients (35/51) of whom 23 were females. The most common co-morbidities were hypertension and obesity, and 24 patients had a history of smoking. We found that patients with CS of the head had a statistically significant higher RR of harbingering pulmonary (1.61) and ocular sarcoidosis (1.29). The results of this small, retrospective, single site study suggest that healthcare providers diagnosing CS of the head as the presenting manifestation of the disease should also explore the presence of clinically quiescent pulmonary and ocular involvement in such cases. We propose that a larger, prospective, multi-site study is warranted to support or refute this hypothesis.