Sarcoidosis with prominent necrosis on histopathology

Sarcoidosis is a multiorgan inflammatory disease with variable clinical presentations and the common histopathologic finding of noncaseating granulomas. The etiology of the disease is not known, but evidence suggests both environmental and genetic contributions to the pathogenesis. Depending on the severity of cutaneous disease and extent of extracutaneous involvement, therapies range from topical and intralesional glucocorticoids to systemic immunomodulatory and immunosuppressive agents. We present the case of a patient with cutaneous sarcoidosis with prominent necrosis on histopathologic examination in the setting of severe pulmonary sarcoidosis.