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Sarcoidosis (Boeck Type). Presented by Dr. Ellen Reiner.
W. N., a 39-year-old man, was first seen in January, 1955, with lesions of one year's duration. The first manifestation was a small papule on the scalp. Gradual spread has taken place so that there is now involvement of the scalp, face, ears, nose, and penis.
In these sites there are annular lesions with firm raised borders and flat centers. Some crusting is present. Around the external nares there are discrete brownish papules. The axillary, right epitrochlear, left postauricular, submaxillary, and submental nodes on both sides are palpable.
A Nickerson-Kveim test was performed on the left forearm, but it is not ready for reading. Tuberculin testing with P. P. D. was negative in the first strength and 2+ in the second strength. The Wassermann and Kahn reactions were negative. The blood calcium was 9.7 mg. per 100 cc.; phosphorus, 2.2 mg.