Sarcoidosis presenting as multiple subcutaneous nodules

We report a young West Indian man who presented with non-specific constitutional symptoms and widespread subcutaneous nodules which were non-diagnostic on histology. The diagnosis of sarcoidosis was made on the basis of progressive bilateral hilar lymphadenopathy, interstitial pulmonary infiltration, a raised serum angiotensin-converting-enzyme level and a granulomatous hepatitis. All symptoms and signs improved dramatically on corticosteroid therapy.