Sarcoidosis: An Update for the Primary Care Physician

Oluranti A. Aladesanmi, MD, MPH

In This Article

Racial and Ethnic Disparities

Racial differences in the clinical manifestations and course of sarcoidosis are well documented; however, there is no specific association between mortality and ethnicity.[10] Black patients are more likely to have extrapulmonary symptoms; constitutional symptoms; severe musculoskeletal symptoms; uveitis, hepatic, bone marrow, or extrathoracic lymph node involvement; lupus pernio; and cystic bone lesions. Their clinical course is more likely to be chronic and progressive, with a worse prognosis.

White patients are more likely to have asymptomatic disease, limited intrathoracic disease, and erythema nodosum, while Japanese patients have a higher prevalence of cardiac and ocular sarcoidosis. Lupus pernio is more common in Puerto Rican and black patients.

Geographic, ethnic, and genetic determinants play a role in these varied clinical manifestations. A 5-fold increase in familial relative risk was demonstrated using a multivariate mode in the ACCESS study,[11] which is consistent with previous evidence of familial clustering.

White individuals had a markedly higher familial relative risk compared with African American individuals, and differential effects of specific alleles on sarcoidosis susceptibility and progression in African American individuals have been identified.[12]


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: