Nail dystrophy and bony involvement in chronic sarcoidosis.

A patient with a chronic course of sarcoidosis with pulmonary and cutaneous involvement presented with dystrophy involving 20 nails. Histologic analysis revealed noncaseating granulomas consistent with nail sarcoidosis, and radiologic evaluation revealed bony cysts typical of sarcoidosis. Nail dystrophy in sarcoidosis is rare; however, when present, it signifies a chronic course of disease. We review the incidence, histopathologic correlation to clinical symptoms, radiologic findings, differential diagnosis, and treatment of nail dystrophy in sarcoidosis.