Vascular lesions in sarcoidosis; probable relationship to steroid therapy.

In two patients with sarcoidosis treated with cortisone, localized vascular lesions, proven by biopsy, subsequently developed. Vascular lesions occurring in sarcoidosis, basically a granulomatous disease, are rarely described. However, a clinical picture of combined arteritis-sarcoidosis with overlapping features is not infrequently observed. Hence clinical differentiation may be difficult. Some observers suggest an interrelationship, perhaps a common etiological grouping in the hypersensitivity disease classification, because of the basic pathological lesions of granuloma and arteritis. The possible relationship of steroid therapy to the development of diffuse vascular lesions or arteritis appears to be gaining recognition, particularly in the case of susceptible patients with rheumatoid arthritis, although in the two cases here reported the disease for which steroids were administered was sarcoidosis and the arterial lesions observed subsequent to therapy were localized rather than diffuse. Since it seems unlikely that arteritis would be part of the clinical manifestations of sarcoidosis, it is implied that a higher incidence of such lesions (localized or diffuse) may be related to prolonged steroid therapy.