Concomitant sarcoidosis, psoriasis, and eczema – immune patterns on the skin

Sarcoidosis is a rare and elusive chronic inflammatory disease. It can manifest itself in any organ, but preferentially affects the lungs and the skin. Our case of an elderly woman with cutaneous and pulmonary sarcoidosis presented with exacerbated itchy, scaly skin changes to our department. The clinical and histopathological findings were consistent with sarcoidosis and eczematized psoriasis. The case represents a unique presentation of sarcoidosis with cutaneous involvement and poses diagnostic and therapeutic challenges due to overlapping clinical features and histology covering the three diagnoses. We discuss the immunological complexities underlying this overlap and resulting possible treatment options, highlighting the role of dermatology in systemic autoimmune diseases involving the skin and the need for pathophysiology-based tailored management approaches in these diseases.