Cutaneous sarcoidosis at insulin injection sites

A diagnosis of sarcoidosis requires a compatible clinical picture, the demonstration of noncaseating granulomas on tissue biopsy and the exclusion of other processes with similar clinical and histopathologic presentations. Although the lung is the most frequently involved organ, about 30% of patients present with extrapulmonary lesions, with cutaneous sarcoidosis affecting up to 25% of all patients.2 Cutaneous involvement may be the first and only manifestation of sarcoidosis, but all patients with cutaneous sarcoidosis should be evaluated and followed up for systemic disease.3 Cutaneous sarcoidosis typically presents as red-brown papules and plaques distributed symmetrically on the face, lips, neck, upper trunk and extremities.3