Sarcoidosis

A nose that bleeds repeatedly, crusts heavily or has lost part of its septum is rarely just chronic rhinosinusitis. This review from the Cleveland Clinic and Hospital Clínic Barcelona walks through five systemic rheumatic diseases that present in the nose: GPA, EGPA, IgG4-related disease, relapsing polychondritis and sarcoidosis. For each it sets out how the nose looks, what the labs, CT and biopsy can and cannot show, and how treatment differs. It also covers when surgery helps (diagnostic biopsy, complications, and reconstruction only once the disease is in remission) and when it does not.

Hair loss in rheumatic disease is rarely just cosmetic — it can mark active inflammation, a drug effect, or an irreversible scarring process. This review walks through the mechanisms behind alopecia in lupus, RA, sarcoidosis, scleroderma and dermatomyositis, the DMARDs that cause shedding, the scarring alopecias that mimic systemic disease, and a stepwise bedside approach for the non-dermatologist.