Lupus Pernio

Lupus pernio is a cutaneous manifestation of sarcoidosis, which was first described in 1889 by Ernest Besnier. It presents as a violaceous lesion or shiny nodules over the head and neck but is predominantly localized to the nose, cheeks, and ears. Cutaneous manifestations of sarcoidosis are estimated to occur in approximately 25 percent of patients and the skin lesions help establish the diagnosis of sarcoidosis. Lupus pernio can present either as an isolated skin lesion or it can be an early manifestation of systemic sarcoidosis. Lupus pernio is often a predictor of systemic sarcoidosis, which warrants thorough workup. Patients with lupus pernio have a higher risk for pulmonary disease, which was confirmed in a retrospective study of 516 patients with sarcoidosis. Pulmonary parenchymal involvement was present more often in patients with lupus pernio or sarcoidosis involving scar tissue (64 and 40 percent, respectively) compared to patients with erythema nodosum or other skin lesions of sarcoidosis.