Reactivation of old scars: inevitably sarcoid.

Reactivation of pre-existing scars, as a manifestation of cutaneous sarcoidosis, is uncommon and the clinical significance of this odd symptom often remains unrecognised. In the appropriate setting a skin biopsy may serve to establish the diagnosis of sarcoidosis and avoid more invasive attempts at obtaining tissue. The case of a 72 year old man with remote reactivation of multiple cutaneous scars associated with a febrile illness, malaise, and hilar adenopathy is reported. A scar biopsy revealed multiple non-caseating granulomas and established the diagnosis of sarcoidosis. A short course of steroids was successful in causing regression of symptoms and cutaneous inflammation. Regression of inflammation in the scar provides a simple way to monitor response to treatment in this multisystem disease.