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Images of Memorable Cases: Case 61

Module by: Herbert L. Fred, MD, Hendrik A. van Dijk. E-mail the authorsEdited By: Frederick Moody

http://rup.rice.edu/memcases-button.jpg

Case_61-pres1-1.jpg

Case_61-pres1-2.jpg

Case_61-pres1-3.jpg

This 42-year-old man had longstanding papules, nodules, and plaques on his face and neck; plaques and psoriasiform lesions on his back, elbows, and axillae; and ichthyotic patches on his legs. All of these abnormalities were asymptomatic.

Asymptomatic nodules, papules, and plaques on the face, shoulders, or extremities strongly suggest sarcoidosis. Diagnostic confirmation requires histologic demonstration of noncaseating granulomas, negative stains and cultures of biopsy specimens for acid-fast bacilli and fungi, and clinical findings consistent with those of sarcoidosis. The patient shown met all of these requirements.

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