Dactylitis and bone lesions are rare complications of sarcoidosis that occur in the chronic disease and they are unusual features of the disease at presentation. The present paper describes a case of a 28-year-old woman with dactylitis (due to tenosynovitis and soft tissue granulomas) and phalangeal bone lesions in 2 fingers at the onset of sarcoidosis. She also had asymptomatic pulmonary type I sarcoidosis (bihilar lymph node enlargement with no involvement of the lung parenchyma). The response to treatment (prednisone 30 mg/day, tapered to 5 mg over 2 months for a 12-month period) was very good, with no relapse at 6 months after the end of systemic treatment.
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