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October 1989

An Ichthyosiform Eruption on the Legs

Author Affiliations

USAF; USA Walter Reed Army Medical Center, Washington, DC

Arch Dermatol. 1989;125(10):1417-1418. doi:10.1001/archderm.1989.01670220113020

REPORT OF A CASE  A 26-year-old woman presented to the dermatology clinic for evaluation of ichthyosiform lesions on her legs. She reported that the eruption began about 6 months previously, when she also began having fevers, night sweats, weight loss, and general malaise. Her medical history was unremarkable.Physical examination disclosed a thin woman with bilateral uveitis. Both legs showed generalized scaling, especially prominent over the anterior tibial areas and characterized by rhomboidal scales with free edges (Fig 1). There were no infiltrative lesions on the legs and the remainder of the cutaneous findings were normal.A biopsy specimen was obtained from the right anterior tibial area (Fig 2).What is your diagnosis?

DIAGNOSIS: Sarcoidosis. 

HISTOPATHOLOGIC FINDINGS  Histologic examination disclosed hyperkeratosis with a decreased to absent granular layer. The epidermis was otherwise unremarkable. Deep in the dermis, a noncaseating epithelioid cell granuloma with minimal surrounding mononuclear