Lupus pernio (Sarcoidosis)
First off, this is a testmanship question. I just discussed unknown rashes, etc. on African American patients being sarcoidosis until proven otherwise, and then I throw out an image of strange papules on the nose, and- imagine that!- he's African American. You could win lots o' dough in Vegas if you were to hit the tables with these kinds of odds in your favor.
Lupus pernio is characteristically violaceous to skin colored, smooth shiny papules and plaques around the nose, cheeks and lips. It is associated in nearly 75% of cases with chronic fibrotic respiratory tract involvement, so the correct diagnosis is important to the patients because the correct treatment can interrupt a cycle of disease that may cripple or rarely kill the patient. Lupus pernio is associated with other manifestations of sarcoidosis, including bony involvement, but the primary risk is the association of the pulmonary tree.
For those of you who got it right, reward yourself by clicking this link: http://www.youtube.com/watch?v=9bZkp7q19f0
If you missed it, click this link: http://www.youtube.com/watch?v=pWS8Mg-JWSg