SKIN LESION – A WINDOW TO A SYSTEMIC DISEASE

Abstract

Sarcoidosis is considered as one of the “great masqueraders” in the eld of dermatology. Polymorphic cutaneous lesions are seen in around 20- 35 % of patients with sarcoidosis. We report a 49 year old male who presented with cough and hypopigmented atrophic plaques over the back. Serum ACE levels and CRP were elevated. HRCT chest revealed parenchymal and hilar, mediastinal lymph node involvement. Skin biopsy was done and showed multiple naked non- caseating granulomas in upper dermis. Pulmonary function test was suggestive of peripheral obstructive airway disease. Bronchoalveolar lavage identied CD4+ lymphocytosis. The patient was started on topical tacrolimus and topical corticosteroids with which he showed improvement. The patient was referred to pulmonology for further management. The case is presented for its rarity, with skin manifestations being one of the presenting signs of the disease.