Cutaneous Sarcoidosis

A 26-year-old man was found to have an asymptomatic, erythematous, non-scaling plaques on the neck and upper back. He thought that the lesions were most likely insect bites.

Key point: These firm, pigmented plaques in a young African American are most likely cutaneous sarcoidosis. This diagnosis was verified by biopsy. A chest radiograph showed bilateral hilar adenopathy, but no parenchymal disease. Pulmonary function test results were normal, as was serum calcium level.

Treatment: The patient’s lesions cleared following oral administration of hydroxychloroquine in a dose of 200 mg twice daily.

Note: Therapy for sarcoidosis is suppressive, not curative. Discontinuation of therapy will generally lead to prompt recurrence of disease.