Case Report Chronic urticaria as the first sign of sarcoidosis

Sarcoidosis is a granulomatous multisystem disease of unclear pathogenesis that can affect any organ.1 The cutaneous manifestations are present in 20 % to 35 % of patients. Skin lesions are classified as specific or nonspe-cific depending on the presence of noncaseating gran-ulomas on histologic studies. Specific lesions include maculopapules, plaques, nodules, lupus pernio, scar infil-tration, alopecia, ulcerative lesions, and hypopigmenta-tion, among other types of lesions. The most common nonspecific lesion is erythema nodosum. Other infrequent cutaneous manifestations include calcifications, prurigo, erythema multiforme, nail clubbing, and acute febrile neu-trophilic dermatosis.2 We report a case of chronic urticaria of unknown cause that, after 6 months of treatment with antihistamines, displayed symptoms consistent with respi-ratory disease associated with systemic involvement