Symptomatic Hypercalcemia and Scarring Alopecia as Presenting Features of Sarcoidosis

This case report described a 60-year-old black woman with sarcoidosis presenting with severe symptomatic hypercalcemia, scarring alopecia, and acute-on-chronic kidney failure. Sarcoidosis, a multisystem granulomatous disease, rarely affects the scalp and presents with hypercalcemia in about 5% of cases. The patient exhibited large scaly plaques with alopecia on the scalp and had elevated serum calcium levels (>14 mg/dL). Treatment included intravenous fluids, calcitonin, and corticosteroids, which improved her calcium levels and kidney function, though not to normal levels. The case highlighted the need for prompt treatment and lifelong monitoring due to the potential for relapses and chronic damage.