A case of extensive subcutaneous sarcoidosis

A 61-year-old female with extensive subcutaneous epithelioid cell granuloma in the back and extremities had negative tuberculin reaction, positive anti-nuclear factor (ANF) and elevated serum angiotensin-converting enzyme (ACE) level while on oral clofibrate for one-and-a-half years because of hyperlipemia. She also suffered from ischemic heart disease with pericardial effusion and dependent edema. The skin surface temperatures over the lesions were about 2°C higher than those of the surrounding normal skin. The subcutaneous lesions cleared spontaneously within 4 months after clofibrate was discontinued. Tuberculin reaction became positive and serum ACE returned to the normal level.