Lupus Pernio

Abstract

A man in his 30s presented with a 3-year history of a painful, pruritic eruptions that affected his face, trunk, and extremities. He had a history of seizures, asthma, and mediastinal and hilar adenopathy incidentally noted on prior chest imaging results. Physical examination revealed indurated violaceous papules on the nasal alae and medial periorbital skin (Figure), hypopigmented indurated plaques on the bilateral upper extremities and back, and verrucous plaques on the lower extremities and back. Histopathologic examination showed a granulomatous infiltrate comprising small nodular aggregates of epithelioid histiocytes with a mild lymphocytic infiltrate in the dermis. Repeated chest imaging results showed interval improvement in adenopathy, and spirometry results were normal. He was treated with hydroxychloroquine, methotrexate, and topical triamcinolone with resolution of cutaneous lesions.Sarcoidosis is a multisystem granulomatous disorder that affects individuals of all ages, sexes, races, and ethnicities. The etiologic agent remains unknown, but the pathogenesis likely involves a complex interplay of a genetic predisposition, appropriate environmental exposure, and resulting immune response. 1 Sarcoidosis most commonly affects the lungs in 90% of patients, and 20% to

Neurosarcoidosis: Diagnostic Challenges and Mimics A Review

“…Ocular inflammation can co-occur with optic neuritis, which we will discuss in the section on cranial nerve palsies. Finally, a wide variety of rashes can manifest, but the clinician should focus on looking for key patterns including erythema nodosum, lupus pernio, and a papulonodular rash affecting tattoos [ 58 – 60 ].…”