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April 1987

Papules and Nodules in a Patient With Sarcoidosis

Author Affiliations

University of Florida College of Medicine and the Gainesville (Fla) Veterans Administration Medical Center

Arch Dermatol. 1987;123(4):521-522. doi:10.1001/archderm.1987.01660280123038

REPORT OF A CASE  A 63-year-old man was referred to the Gainesville (Fla) Veterans Administration Medical Center dermatology clinic with a six-month history of asymptomatic papules on his left arm and an enlarging tender nodule on his left leg. He had been referred by his pulmonary physician with a tentative diagnosis of cutaneous sarcoidosis.A diagnosis of systemic sarcoidosis was made one year earlier, when the patient had presented with fatigue, 15-kg weight loss, and hypercalcemia. A left hilar mass was found on chest roentgenogram, and the biopsy of this mass at mediastinoscopy revealed a lymph node with noncaseating granulomas, consistent with sarcoidosis. Special stains and cultures of the biopsy specimen were negative. Prednisone therapy (30 mg/d) was started, with prompt improvement in the patient's symptoms and resolution of the hypercalcemia. No skin lesions had been noted at the time of this initial workup.Five months prior to referral and

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