TOPLINE:

In a study of patients with cutaneous sarcoidosis, ECG abnormalities identified all cases of cardiac involvement, demonstrating 100% sensitivity and 100% negative predictive value.

METHODOLOGY:

• Researchers conducted a cross-sectional study involving 170 patients (mean age, 50 years; 64.7% women; 68.8% White and 20.6% Black individuals) with cutaneous sarcoidosis between October 2015 and June 2022 from the Mass General Brigham Research Patient Data Registry.
• The analysis included a review of cardiac symptoms, ECG findings, and cardiovascular imaging studies within 1 year of the cutaneous sarcoidosis diagnosis. Of the 152 (89.4%) patients who underwent ECG screening, 79 (46.5%) showed abnormalities, and seven (4.1%) met cardiac sarcoidosis criteria.
• The researchers evaluated the diagnostic performance of ECG and review of systems (ROS) in detecting cardiac sarcoidosis during initial screening within 1 year of the cutaneous sarcoidosis presentation.

TAKEAWAY:

• Three of the seven patients with cardiac sarcoidosis reported symptoms, but all seven had abnormal ECGs.
• ECG abnormalities detected all cases of cardiac sarcoidosis, yielding 100% sensitivity and a 100% negative predictive value.
• Combining ECG with ROS that detected cardiac symptoms yielded the highest specificity at 87.5% and overall accuracy at 78.6%.
• All patients with cardiac sarcoidosis had other extracutaneous manifestations.

IN PRACTICE:

“Although the 2014 [Heart Rhythm Society] consensus recommends baseline ECG and ROS for all patients with sarcoidosis, specific guidance for those with [cutaneous sarcoidosis] is sparse,” the study authors wrote. “These findings reinforce the value of ECG screening in [cutaneous sarcoidosis] and as a practical tool in dermatologic evaluation.”

SOURCE:

The study was led by Eric Xia, MD, Department of Dermatology, Brigham and Women’s Hospital, Boston, and was published online on September 17 in JAMA Dermatology.

LIMITATIONS:

Study limitations included missing data and small number of cardiac sarcoidosis cases. Additionally, variations in detection thresholds and cohort composition, including race and ethnicity factors, could have influenced the observed cases.

DISCLOSURES:

This work was supported by awards from Brigham and Women’s Hospital. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.