Skin nontumor
Dermal granulomatous and necrobiotic reaction patterns
Sarcoidosis


Topic Completed: 1 July 2011

Minor changes: 23 July 2020

Copyright: 2002-2020, PathologyOutlines.com, Inc.

PubMed Search: Sarcoidosis [title] skin

Mowafak Hamodat, M.B.Ch.B., M.Sc.
Page views in 2019: 14,075
Page views in 2020 to date: 11,353
Cite this page: Hamodat M. Sarcoidosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumorsarcoidosis.html. Accessed October 20th, 2020.
Definition / general
  • Affects skin, lymph nodes and organs
  • Diagnosis of exclusion
  • Patients often have anergy to delayed hypersensitivity tests
Epidemiology
  • May present with acute, self-limiting disease, as a chronic form exclusively affecting the skin or with a serious systemic variant with widespread lesions
  • Etiology is unknown
Clinical images

Images hosted on other servers:

39 year old man with systemic sarcoidosis

Cutaneous findings in systemic sarcoidosis

Microscopic (histologic) description
  • Inflammatory and granulomatous reactions with dense superficial and deep lymphocytes, eosinophils and plasma cells
  • Variable parakeratosis, spongiosis, acanthosis and epidermal erosion
  • May have lymphoid germinal centers resembling lymphoma with destruction of adnexae and atypia
  • Dense, noncaseating granulomatous infiltrate in the dermis extends into subcutaneous fat; granulomas are discrete and uniform in size and shape; composed of epitheloid histiocytes with abundant eosinophilic cytoplasm and oval nuclei containing a small central nucleolus
  • Variable Langhans giant cells, and scattered lymphocytes
  • Discrete, small central foci of fibrinoid necrosis are present; also transepidermal elimination
  • Also Schaumann bodies (calcium and protein inclusions inside of Langhans giant cells as part of a granuloma; basophilic laminated rounded conchoidal structures), asteroid bodies (small, intracytoplasmic, eosinophilic star shaped structure also present in tuberculoid leprosy, berylliosis and atypical facial necrobiotic xanthogranuloma), Hamazaki-Wesenberg bodies (peculiar PAS+ inclusions, may be large lysosomes containing hemolipofuscin)

  • Note: foreign material in sarcoidal granulomata does not exclude the diagnosis of sarcoidosis
Microscopic (histologic) images

Contributed by Jijgee Munkhdelger, M.D., Ph.D., Andrey Bychkov, M.D., Ph.D. and Dr. Josehp Christopher Castillo Cuenca
Missing Image

Schaumann body

Missing Image

Schaumann bodies

Missing Image

Asteroid body

Missing Image

Low power

Missing Image

Non-caseating granulomas

Missing Image

Extension to subcutaneous fat tssue


Missing Image

Langhans giant cells

Various images



Images hosted on other servers:

Various images


Asteroid bodies

Hamazaki-Wesenberg bodies

Positive stains
Differential diagnosis
Back to top
Image 01 Image 02