Lupus pernio is a specific and potentially disfiguring presentation of cutaneous sarcoidosis characterised by chronic lesions on the face — particularly on or around the nose, around the eyes, and around the mouth. This distinct skin manifestation of sarcoidosis calls for a targeted management approach.
Unlike other cutaneous sarcoid lesions — such as skin nodules on old scars or tattoos, or lesions resembling psoriasis — lupus pernio presents with facial involvement and carries particular cosmetic and clinical significance. Correct identification of this pattern is the starting point for appropriate treatment selection.
Management of lupus pernio typically involves steroid-sparing agents. Hydroxychloroquine is often an early option in this setting, and cytotoxic drugs may be incorporated depending on the clinical picture. The complete agent selection, sequencing, and monitoring plan are available in the full structured protocol.
Other specific skin lesions include skin nodules that develop on old scars and tattoos; lesions that look like ulcers; lesions that may be mistaken for psoriasis; and lupus pernio, potentially disfiguring lesions that occur on the face, particularly on or around the nose, around the eyes or mouth.
Hydroxychloroquine is often the first steroid-sparing drug used.
Among the cytotoxic drugs, methotrexate seems to have a better response rate than other agents.
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