SARCOIDOSIS OF HANDS

The various manifestations of the complex disease known as sarcoidosis have only been recognised in recent years. The stages in its recognition have been well summarised by Gray (1941). In 1889 Besnier described a symmetrical granulomatous condition of the nose, ears and fingers which he called “ lupus pernio. ” In 1899 Boeck reported a skin disorder characterised by the appearance on the face of granulomatous swellings resembling lupus vulgaris, and coined the name “ cutaneous sarcoid. ” It was recognised in 1898 by Hutchinson, who called it “ Mortimer’s malady ” after the patient concerned. In 1917 Schaumann showed that these conditions were variants of the same disease and merely cutaneous manifestations of a disorder affecting many organs such as the lymphatic system, the bone marrow, the lungs and other viscera. According to Ellis (1940), JUngling in 1920 reported sarcoid lesions of the bones of the extremities under the title “ osteitis tuberculosa multiplex cystica. ” Later he substituted the word “ cystoides “ for “ cystica, ” because the lesions are in fact solid and only appear cystic in the radiographs. Ellis emphasised that JUngling’s disease is not cystic tuberculosis of bone, and that the radiographic appearance is due to replacement of bone and marrow b