A Case of Sarcoidal Granulomatous Dermatitis and Vasculitis in a 28-Year-Old Woman

Granulomatous vasculitis represents a rare cutaneous manifestation of sarcoidosis, a multisystem disease characterized by noncaseating granulomas. We report the case of a 28-year-old woman with new-onset tender, nonpruritic, erythematous papules coalescing into plaques and subcutaneous nodules on her lower legs, accompanied by anterior uveitis, exertional dyspnea, and constitutional symptoms including fatigue and night sweats. Punch biopsy revealed non-necrotizing epithelioid granulomas with vasculitic changes, consistent with cutaneous sarcoidal granulomatous vasculitis. Although granulomatous vasculitis is well recognized in pulmonary sarcoidosis, its presence in the skin can complicate diagnosis and delay appropriate therapy. This report highlights the value of histopathologic evaluation of suspicious lesions in patients with possible sarcoidosis. Collaborative care between dermatology, rheumatology, ophthalmology, and pulmonology is key for timely intervention and improved patient outcomes.