A man in his 30s presented with a 3-year history of a painful, pruritic eruptions that affected his face, trunk, and extremities. He had a history of seizures, asthma, and mediastinal and hilar adenopathy incidentally noted on prior chest imaging results. Physical examination revealed indurated violaceous papules on the nasal alae and medial periorbital skin (Figure), hypopigmented indurated plaques on the bilateral upper extremities and back, and verrucous plaques on the lower extremities and back. Histopathologic examination showed a granulomatous infiltrate comprising small nodular aggregates of epithelioid histiocytes with a mild lymphocytic infiltrate in the dermis. Repeated chest imaging results showed interval improvement in adenopathy, and spirometry results were normal. He was treated with hydroxychloroquine, methotrexate, and topical triamcinolone with resolution of cutaneous lesions.
Popatia S, Wanat KA. Lupus Pernio. JAMA Dermatol. 2022;158(4):446. doi:10.1001/jamadermatol.2021.6007
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