“The earliest known clinical description of sarcoidosis was recorded by Jonathan Hutchinson in 1875, who observed purplish, nodular, sharply circumscribed lesions on a patient’s fingers, forearms, and legs, along with nontender swelling of a finger, marking the first recognition of the disease in medical literature.

In 1877, the Norwegian physician C.W. Boeck described a peculiar skin lesion that would later be recognized as a manifestation of sarcoidosis.

The term “sarcoidosis” was introduced in 1899 by the British dermatologist Robert J. W. Hutchinson, who highlighted the systemic nature of the condition, distinguishing it from other skin diseases and tuberculosis-like conditions. Early on, the disease was primarily considered a dermatological curiosity, but by the early 20th century, its systemic involvement, including the lungs, lymph nodes, and other organs, became evident.

Over the decades, understanding of sarcoidosis expanded significantly, with advances in radiographic imaging, histopathology, and immunology clarifying its multisystem nature. Despite these developments, the exact cause remains unknown, though genetic predisposition and environmental triggers are implicated. Today, sarcoidosis is recognized as a non-infectious granulomatous disease that can affect multiple organs, with skin manifestations being among the earliest observed signs.”

JAMA Dermatology (SARCOIDOSIS | JAMA Dermatology | JAMA Network) and SPRYPT.com (The Historical Context of Sarcoidosis)

How Sarcoidosis can be diagnosed:

• biopsy of the lungs, liver, skin, or other affected organs to check for granulomas
• Blood tests, including complete blood counts, to check hormone levels and to test for other conditions that may cause sarcoidosis
• Bronchoscopy, which may include rinsing an area of the lung to get cells or using a needle to take cells from the lymph nodes in the chest
• Chest X-ray to look for granulomas in the lungs and heart and determine the stage of the disease. Often, sarcoidosis is found because a chest X-ray is performed for another reason.
• Neurological tests, such as electromyography, evoked potentials, spinal taps, or nerve conduction tests, to detect problems with the nervous system caused by sarcoidosis
• Eye exam to look for eye damage, which can occur without symptoms in a person with sarcoidosis
• Gallium scan external link , which uses a radioactive material called gallium to look for inflammation, usually in the eyes or lymph nodes.
• High-resolution computed tomography (CT) scan to look for granulomas
• Magnetic resonance imaging (MRI) to help find granulomas. Learn more in our Chest MRI Health Topic.
• Positron electron tomography (PET) scan, a type of imaging that can help find granulomas
• Pulmonary function tests to check whether you have breathing problems
• Ultrasound to look for granulomas

There is a staging to Sarcoidosis:

“There are many risk factors for sarcoidosis. Some risk factors, such as where you work, can be changed. But your age, family history, and many other risk factors cannot be changed.

Age: You can get sarcoidosis at any age, but the risk goes up as you get older, especially after age 55.

Environment: Living or working near insecticides, mold, or other substances that may cause inflammation raises your risk. You may be around these substances if you are in health care or the automotive industry or are a farmer or firefighter.

Family history and genetics: Having a close relative with sarcoidosis raises your risk.

Medicines: Certain types of HIV medicines and monoclonal antibodies(link is external) used to treat cancer or overactive immune system can raise your risk.

Race or ethnicity: Your risk is higher if you are of African or Scandinavian descent.

Sex: Women are more likely to have sarcoidosis, although men can also have it.

Other medical conditions, such as lymphoma, a type of blood cancer, can also lead to sarcoidosis.”

NIH National Library of Medicine (https://pmc.ncbi.nlm.nih.gov/articles/PMC7755458/)

Lung lesions – 95% Thoracic lymph nodes – 50% Skin lesions – 30%  Eyes – 30%

Inflammatory Disease- Sarcoidosis or Sarcoid is a inflammatory disease that consists of granuloma.

Wide Spread Disease- Disease is wide spread in multiple organs.

• The Sarcoidosis disease tends to come and go all of a sudden.
• Disease may progressively develop as a serious illness.
• Patient may experience several relapse throughout the life.

• Sarcoidosis or Sarcoid is a gradual progressive disease.
• Microscopic lumps called granulomas start to appear in the affected organs.¹
• In most of the cases, these granulomas tend to clear with or without treatments.
• There are few instances where granuloma grows in size and continues to be a part of the organ.
• Granuloma eventually ends up as fibrotic lump but may cause several complications.

Causes

Doctors don’t know the exact cause of sarcoidosis. Some people appear to have a genetic predisposition to develop the disease, which may be triggered by bacteria, viruses, dust or chemicals.

This triggers an overreaction of your immune system and immune cells begin to collect in a pattern of inflammation called granulomas. As granulomas build up in an organ, the function of that organ can be affected.

Risk factors

While anyone can develop sarcoidosis, factors that may increase your risk include:

• Age and sex. Sarcoidosis often occurs between the ages of 20 and 40. Women are slightly more likely to develop the disease.
• Race. African-Americans have a higher incidence of sarcoidosis than do white Americans. Also, sarcoidosis may be more severe and may be more likely to recur and cause lung problems in African-Americans.
• Family history. If someone in your family has had sarcoidosis, you’re more likely to develop the disease.

Complications

For most people, sarcoidosis resolves on its own with no lasting consequences. But sometimes it causes long-term problems.

• Lungs. Untreated pulmonary sarcoidosis can lead to permanent scarring in your lungs, making it difficult to breathe.
• Eyes. Inflammation can affect almost any part of your eye and can eventually cause blindness. Rarely, sarcoidosis also can cause cataracts and glaucoma.
• Kidneys. Sarcoidosis can affect how your body handles calcium, which can lead to kidney failure.
• Heart. Granulomas in your heart can cause abnormal heart rhythms and other heart problems. In rare instances, this may lead to death.
• Nervous system. A small number of people with sarcoidosis develop problems related to the central nervous system when granulomas form in the brain and spinal cord. Inflammation in the facial nerves, for example, can cause facial paralysis.

“Sarcoidosis is an illness that causes tiny islands of inflammatory cells to form throughout the body. These microscopic groups of cells are called granulomas. They are especially common in the lungs, lymph nodes, skin, eyes, and liver. The cause of sarcoidosis is unknown.

Sometimes these granulomas cause very little damage, so a person with sarcoidosis does not have any symptoms of illness and may not even know they have it. In other cases, however, the granulomas produce large areas of inflammation and scarring that can interfere with an organ’s normal functions.”

Harvard Health (Sarcoidosis – Harvard Health)

Sarcoidosis (pronounced SAR-COY-DOE-SIS) is an inflammatory disease characterized by the formation of granulomas, tiny clumps of inflammatory cells, in one or more organs of the body. When the immune system goes into overdrive and too many of these clumps form, they can interfere with an organ’s structure and function. When left unchecked, chronic inflammation can lead to fibrosis, which is permanent thickening or scarring of organ tissue.

This disorder can affect almost any organ in the body, including the heart, skin, liver, kidneys, brain, sinuses, eyes, muscles, bones, and other areas. Sarcoidosis most commonly targets the lungs and the lymph nodes, which are an important part of the immune system. When it affects the lungs, it is called pulmonary sarcoidosis. Ninety percent or more of people diagnosed with the disease have lung involvement.

Doctors believe sarcoidosis results from the body’s immune system responding to an unknown substance, most likely something inhaled from the air.

Symptoms in general to people affected by this disease sarcoidosis:

For many people, sarcoidosis begins with these symptoms in general:

“The Cleveland Clinic states that cataract surgery is one of the most common procedures, with surgeons performing more than 3 million cataract surgeries in the United States, and 20 million globally, improving vision for 97 percent of patients. For those who have had cataract surgery recommended by their eye doctors,”

Prevent Blindness (Cataract Awareness Month 2024: Essential Eye Health Tips)

Medications that can cause Cataracts:

Certain medications are well-known causes of cataracts, and some drugs can also accelerate their development. Steroid medications – whether pills, injections, or eye drops – are most frequently associated with cataract formation. If you are taking steroid medications to manage a long-term condition, it is important to note any visual changes and to have your ocular health managed by a qualified ophthalmologist. The medications that can cause cataracts include:  Corticosteroids, Eye drops containing steroids, Glaucoma medications, Certain antipsychotics and antidepressants, Certain medications for autoimmune conditions, and Medication to control heart arrhythmia

Signs and Symptoms of Cataracts:

You may not have any symptoms at first, when cataracts are mild. But as cataracts grow, they can cause changes in your vision. For example, you may notice that:

• Your vision is cloudy or blurry
• Colors look faded
• You can’t see well at night
• Lamps, sunlight, or headlights seem too bright
• You see a halo around lights
• You see double (this sometimes goes away as the cataract gets bigger)
• You have to change the prescription for your glasses often

These symptoms can be a sign of other eye problems, too. Be sure to talk to your eye doctor if you have any of these problems.

HOW YOU CAN PREVENT CATARACTS:

Maintaining healthy eating habits can help to prevent cataracts in two ways. First, a good diet will control your weight, thus eliminating one of the significant risk factors. Second, increasing your antioxidant intake can also inhibit the oxidation process. In a 2013 Swedish, researchers observed 30,000 women over age 49, and found that those who consumed the highest amounts of antioxidants had a 13 percent lower chance of developing cataracts than those who consumed the least amounts.

To reduce your risk for cataracts, be sure to eat plenty of foods high in antioxidants.

TREATMENTS FOR CATARACTS:

“Did you know that cataracts are the leading cause of blindness worldwide? Did you know that cataracts can be treated with cataract surgery, one of the most common elective procedures in the U.S.? Did you know cataract surgery and its ability to restore vision has been associated with significant improvements in quality of life?

Well, this Cataract Awareness Month, ASCRS, the largest specialty society in the U.S. dedicated to cataract surgery education and the needs of anterior segment surgeons with input from member ophthalmologist on what they want patients to know most, has put together materials to help patients and caregivers better understand cataracts and cataract surgery.”

American Society of Cataract and Refractory Surgery  (Cataract Awareness Month | ASCRS)

A cataract is a cloudy area in the lens of your eye. Cataracts are very common as you get older. In fact, more than half of all Americans age 80 or older either have cataracts or have had surgery to get rid of cataracts.

At first, you may not notice that you have a cataract. But over time, cataracts can make your vision blurry, hazy, or less colorful. You may have trouble reading or doing other everyday activities.

There are 3 types of Cataracts:

1-Nuclear cataracts, which form in the lens’ nucleus, are the most common type of cataracts. Because opacity develops in the center of the lens, known as the central nucleus, nuclear cataracts interfere with a person’s ability to see objects in the distance. Usually the result of advancing age, nuclear cataracts can take years to develop and often give the nucleus a yellow tint.

2=Cortical cataracts begin at the outer rim of the lens and gradually work toward the central core. Thus, this type of cataract resembles spokes of a wheel. Patients with cortical cataracts often notice problems with glare, or a “halo” effect around lights. They may also experience a disruption of both near and distance vision.

3-Subcapsular cataracts progress the most rapidly. While nuclear cataracts take years to develop, subcapsular cataracts reach an advanced stage within a matter of months. Posterior subcapsular cataracts affect the back of the lens, causing glare and blurriness. This type of cataract is usually seen in patients who suffer from diabetes, extreme nearsightedness or retinitus pigmentosa, as well as among those who take steroid medication.

Obesity is most commonly linked to the development of posterior subcapsular cataracts. According to researchers at Harvard University, individuals with a BMI of 33 had at least a 30 percent greater likelihood of developing cataracts, compared to subjects with a BMI of 23 or below.

**Congenital cataracts exist and refer to cataracts that are present from birth, as well as to those that develop in early childhood. These cataracts can be nuclear, cortical, or subcapsular. Congenital cataracts may be linked to an infection contracted by the mother during pregnancy or to a genetic condition such as Fabry disease, Alport syndrome, or galactosemia. Because clear vision is essential to the development of the child’s eyes and brain, it is important to diagnose congenital cataracts as early as possible.

Most cataracts form as a result of advancing age. Other possible causes of cataracts include environmental factors and certain medications, such as antidepressants. If your medical history or lifestyle increases your risk of developing cataracts, it is important to have your eye health monitored regularly by a qualified ophthalmologist.

Over 50 percent of Americans over the age of 80 have cataracts

RISK FACTORS:

1 Age

Age is the main reason cataracts form. According to the American Academy of Ophthalmology, the eye disease appears in over 22 million Americans over the age of 40. Over 50 percent of Americans over the age of 80 have cataracts. In fact, if we live long enough, nearly all of us will eventually develop this condition. Because the lens of the eye cannot shed old cells naturally, protein that accumulates on the lens gradually builds up over time, progressively obscuring vision by preventing light from reaching the retina.

2 History of Cataracts in the family

3 Ultraviolet Radiation (UVA or UVB)

According to the U.S. Environmental Protection Agency, long-term exposure to ultraviolet radiation, especially UVB rays, can cause changes in pigment that lead to the formation of cataracts. This is especially common in tropical climates, where high concentrations of UV exposure occur year-round. To protect the eyes from sun damage, it is important to wear sunglasses with a high level of UVA/UVB protection.

4 Trauma to the eye

Injury or trauma to the eye increases a patient’s risk of developing cataracts. Individuals who have experienced inflammation in the eye, either post-operatively or as the result of another eye disease, are also more likely to eventually develop cataracts. For instance, iritis is an ocular condition that causes chronic inflammation inside the eye, and is commonly linked to early and rapid cataract formation.

5 Have certain health problems, like diabetes

6 Smoking and Alcohol

Lifestyle habits such as smoking or consuming alcohol are often considered causes of cataracts.

7 Medications

Certain medications are well-known causes of cataracts, and some drugs can also accelerate their development. Steroid medications – whether pills, injections, or eye drops – are most frequently associated with cataract formation. If you are taking steroid medications to manage a long-term condition, it is important to note any visual changes and to have your ocular health managed by a qualified ophthalmologist.

Most cataracts are caused by normal changes in your eyes as you get older.

When you’re young, the lens in your eye is clear. Around age 40, the proteins in t he lens of your eye start to break down and clump together. This clump makes a cloudy area on your lens — or a cataract. Over time, the cataract gets more severe and clouds more of the lens.