When The Skin Speaks For The Lungs: A Case Of Sarcoidosis With Erythema Nodosum

Huda Allaham^(1,*), Denisa Predețeanu⁽²⁾, Mădălina-Pușa Roșu⁽²⁾

1)Department of Internal Medicine, “Th. Burghelea” Clinical Hospital, Bucharest, Romania
2)“Department of Rheumatology, “Sf. Maria” Clinical Hospital, Bucharest, Romania

Erythema nodosum (EN) is a common but nonspecific form of panniculitis that may serve as an early cutaneous marker for systemic disease, including sarcoidosis. We report the case of a 32-year-old male who presented with painful erythematous nodules on both lower legs, bilateral ankle arthritis, and systemic inflammatory symptoms. Chest imaging revealed bilateral hilar lymphadenopathy and diffuse pulmonary micronodules. Laboratory investigations showed marked inflammatory markers and autoimmune thyroiditis. The constellation of findings was consistent with Löfgren syndrome - a well-defined acute presentation of sarcoidosis characterized by EN, arthritis, and bilateral hilar adenopathy. The patient responded favorably to corticosteroid therapy. This case underscores the diagnostic value of erythema nodosum as a clinical clue to underlying sarcoidosis and highlights the need for thorough systemic evaluation when EN is present.

Keywords: sarcoidosis, Löfgren syndrome, erythema nodosum, arthritis, autoimmune thyroiditis

Corresponding author(s): Huda Allaham, Department of Internal Medicine, “Th. Burghelea” Clinical Hospital, Bucharest, Romania; email: hudaallaham18@gmail.com