[A toxic syndrome and subcutaneous nodules as the only clinical manifestation of systemic sarcoidosis].

Sarcoidosis is a systemic disease with frequent cutaneous manifestations. Among these exists a predominance of the so-called unspecific lesions because of their histopathological features. Within the specific lesions, that is those which showed non-caseous granulomas, subcutaneous nodules are underlined, which have been associated with chronic sarcoidosis with a frequency of 1.4%-6%. These lesions appear during the evolution of the disease but rarely constitute an initial manifestation of it. The patient whose case is discussed had a debut with toxic syndrome and subcutaneous nodules. Histopathological study of these nodules showed the existence of non caseous granulomas formed by histiocytes, epithelioid cells, Langhans and foreign body giant cells. Lobulet hepatic granulomas were showed together with mediastinal pulmonary captation of gallium. We conclude that sarcoidosis must be considered when performing the differential diagnosis of the disease which debut with subcutaneous nodules.