Cutaneous involvement occurs in approximately one third of the patients with sarcoidosis.1 Cutaneous nodules as the initial manifestation of sarcoidosis is much less common,2 and the localization of such lesions on the palms and soles seems to be unusual. This article describes a patient with nodular lesions of the hands and feet that, on biopsy, showed histologic changes consistent with a diagnosis of sarcoidosis.
Fig 1.—One-centimeter nodular lesion with overlying hyperpigmentation on left palm.
Report of a Case
A 49-year-old hypertensive black woman was admitted to Norfolk (Va) Community Hospital complaining of left calf pain that had been present for two weeks. She had no chest pain or cough, but she had noted mild exertional dyspnea and easy fatigability for the past month. In the three weeks before her admission to the hospital, asymptomatic nodules developed on her left palm and her right sole. Some papules had also