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Health condition

Sarcoidosis of the skin

Sarcoidosis can involve the skin in around a quarter of cases, producing red-brown papules, plaques, scar infiltration or the distinctive lupus pernio - and because skin lesions are easy to biopsy, they are often the fastest route to diagnosis.

Why trust this guide

  • 01

    Editorial team

    Written by our editorial team from the UK sources listed on each page.

  • 02

    Sourced from guidance

    Checked against current NHS and UK specialist society guidance at the time of review.

  • 03

    Current for 2026

    Reviewed on 2026-09-27 with the next review scheduled for 2027-09-27.

Key facts

The essentials at a glance.

The symptoms to recognise, when to seek help, which specialist to see, and what treatment usually involves.

  • Red-brown or violaceous papules and plaques, often on the face, neck and around old scars or tattoos

  • Lupus pernio - bluish-purple swelling of the nose, cheeks and ears - is associated with chronic multi-organ disease

  • Skin biopsy showing non-caseating granulomas confirms sarcoidosis with minimal risk

  • Every skin diagnosis triggers screening of lungs, eyes, heart and calcium levels for systemic involvement

Understanding the condition

What it is and what happens next.

What causes it, how it is diagnosed, and the treatment routes available in the UK.

What it is and how it feels

In sarcoidosis the immune system builds granulomas - tight knots of macrophages - in affected tissues, and in the skin these appear as firm, smooth, red-brown lesions that show an "apple jelly" colour when pressed with a glass slide. Old scars and tattoos that suddenly become raised and inflamed are a classic and easily missed presentation.

Diagnosis and treatment routes

A skin biopsy provides tissue confirmation far more safely than lung or lymph node sampling, after which assessment includes a chest X-ray or CT, lung function tests, ECG, eye examination and blood calcium. Limited skin disease may need only potent topical or injected steroids; widespread or disfiguring disease, particularly lupus pernio, is treated with hydroxychloroquine, methotrexate or biologic therapy in a specialist clinic. In much of the UK, a routine NHS referral to the relevant specialist clinic can take several months, whereas an initial appointment with a private consultant is typically available within around two weeks.

Seeing a specialist

Who to see, and how quickly you can be seen.

The specialist for this condition is usually a consultant dermatologist. Your GP can refer you on the NHS, or you can arrange a private consultation directly.

A quiet reminder

This guide is for information, not medical advice.

Your GP knows your history and can tell you which parts apply to you. If in doubt, see them - and seek urgent care for any of the emergency symptoms described above.

Frequently asked

Common questions about Sarcoidosis of the skin.

Quick, plain-English answers to what people ask us most.

  • What is sarcoidosis of the skin?

    Sarcoidosis can involve the skin in around a quarter of cases, producing red-brown papules, plaques, scar infiltration, or the distinctive lupus pernio - dusky, swollen plaques typically on the nose and cheeks.

  • What causes skin sarcoidosis?

    It results from the same granulomatous inflammatory process seen in sarcoidosis elsewhere in the body, forming small collections of inflammatory cells within the skin.

  • What are the symptoms of skin sarcoidosis?

    Symptoms include red-brown or purplish raised patches or plaques, sometimes affecting old scars, or the more specific lupus pernio pattern affecting the nose and cheeks.

  • Is skin sarcoidosis dangerous?

    Skin involvement itself is not dangerous, but because sarcoidosis can affect other organs, especially the lungs, skin findings often prompt a wider check for internal involvement.

  • How is skin sarcoidosis treated?

    Treatment includes topical or injected steroids for localised lesions, and systemic medication such as oral steroids or immunosuppressants for more widespread or disfiguring disease.

  • How is skin sarcoidosis diagnosed?

    Diagnosis is typically confirmed with a skin biopsy showing the characteristic granulomas, alongside investigation for internal organ involvement, particularly of the lungs.

  • Skin sarcoidosis vs lupus - what's the difference?

    Despite the similar-sounding name, lupus pernio in sarcoidosis is a distinct condition from lupus erythematosus; biopsy helps confirm sarcoidosis and distinguish it from other skin conditions with a similar appearance.

  • When should I see a dermatologist about skin changes suggesting sarcoidosis?

    See a doctor for unexplained red-brown skin plaques or changes to old scars. A private dermatologist can typically be seen within about two weeks.