Papular Sarcoidosis

Sarcoidosis is a systemic granulomatous disease of unknown etiology which involves botht he skin and other internal organs, including lungs, lymph nodes, myocardium and CNS.

Interestingly, in Europe, the disease is primarily found in rural areas particularly in Scandinavia, and inthe US it happens to be more concentrated in African Americans than the general population.  The lesions are primarily papular, but can be verrucous, erythematous, psoriasiform and alopetic.

The lesions are usually asymptomatic, and concentrated over the head and neck, as well as the upper trunk.  The ddx would include benign adnexal tumors, disseminated deep fungal infection in immunocompromised individuals, or xanthelasma.    The clues in this individual are the papules that are clustered around the eyes and nose, as well as the race.