Microscopic examination of a specimen from the scalp showed the presence of dermal noncaseating epithelioid granulomas. The epidermis was hyperkeratotic, with areas of orthokeratosis and parakeratosis.
A complete blood cell count and serum protein, calcium, and phosphate levels were normal. The chest radiograph showed enlarged hila with diffuse fine opacities throughout both lungs. Pulmonary function tests revealed the following abnormalities: forced expiratory volume in 1 second, 1.19 L (reference value, 1.73 L); forced expiratory volume in 1 second–forced vital capacity ratio, 69.5% (reference value, 76.9%); and forced vital capacity, 1.71 L (reference value, 2.09 L). Transbranchial lung biopsy specimens showed noncaseating epithelioid granulomas.
Erythematous Lesions on the Scalp—Diagnosis. Arch Dermatol. 2004;140(8):1003-1008. doi:10.1001/archderm.140.8.1003-h