Chronic Facial Sarcoidosis Including Lupus Pernio

Background: Facial lesions including lupus pernio are often a form of chronic cutaneous sarcoidosis. Objective: To evaluate the intra- and inter-observer consistency of objective measures of chronic facial lesions. Method: This was a retrospective study of patients with chronic cutaneous facial lesions including lupus pernio. The lesions were evaluated using two methods. Results: Of the 25 patients studied, 23 were women and 24 were African American. Lungs (24 patients), sinuses (11 patients), and eyes (7 patients) were also affected. The Sarcoidosis Activity and Severity Index (SASI) characterized individual areas of the face, with 95% of the observations being less than 2 points from the median. A facial SASI total gave a score for the entire face and 93.2% of the scores were within 3 points of the median. Conclusion: Patients with sarcoidosis and chronic facial lesions often have lung, sinus, and eye involvement. The SASI is a reproducible scoring system for chronic facial lesions.