Abstract | November 18, 2023
Skin to Heart via Skull: the Journey of Sarcoidosis
Learning Objectives
- Highlight the unique presentation and rare organ involvement involved in Sarcoidosis
- Consider cardiac sarcoidosis screening in patients with extra-cardiac sarcoidosis
Introduction
Systemic sarcoidosis is a non-caseating granulomatous disorder affecting multiple organs. Cutaneous manifestations are seen in about 25% of cases of sarcoidosis, whereas cardiac involvement occurs in about 5 to 10% of cases. Sarcoidosis affecting skull bone is extremely rare.
Case Presentation
We report a 66-year-old Caucasian woman with a history of cutaneous sarcoidosis who presented with transient ischemic attack. Multiple lytic lesions involving the skull bone were found on the brain MRI without any infarct evidence. The patient returned to the clinic 12 months later with recurrent syncope due to intermittent 3rd-degree heart block.
Final/Working Diagnosis
Cardiac MRI confirmed the diagnosis of cardiac sarcoidosis.
Management
This case represents a unique journey of sarcoidosis and opens up potential consideration for cardiac sarcoidosis screening in patients with extra-cardiac sarcoidosis.
References and Resources
- Okada DR, Bravo PE, Vita T, et al. Isolated cardiac sarcoidosis: A focused review of an under-recognized entity. J Nucl Cardiol 2018; 25:1136.
- Robles LA, Matilla AF, Covarrubias MP. Sarcoidosis of the Skull: A Systematic Review. World Neurosurg. 2020 Jul;139:387-394. doi: 10.1016/j.wneu.2020.04.114. Epub 2020 Apr 24. PMID: 32339731.
- Hanno R, Needelman A, Eiferman RA, Callen JP. Cutaneous sarcoidal granulomas and the development of systemic sarcoidosis. Arch Dermatol 1981; 117:203.
- English JC 3rd, Patel PJ, Greer KE. Sarcoidosis. J Am Acad Dermatol 2001; 44:725.
