Sarcoidosis with bilateral leg lymphedema as the initial presentation: a review of the literature

Sarcoidosis is a granulomatous disease, characterized microscopically by noncaseating granulomas, which may involve multiple organs; however, the lung, skin, and lymph nodes are commonly affected. Sarcoidosis is a great imitator; in the skin, it presents with different cutaneous manifestations including lupus pernio, infiltrated plaques, maculopapular eruptions, infiltration of old scars, and subcutaneous sarcoidosis. Lymphedema as an initial presentation is extremely rare; cases are reported in African-American but not Asian patients. Lymphedema associated with sarcoidosis may result from lymphatic obstruction by infiltrating sarcoidosis. We present a case where the symptoms and signs of sarcoidosis were improved after treatment with systemic steroids.