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Frieden and coworkers have decided that the case of sarcoidosis in a child that we presented in the December 1989 issue of the Archives is, in their opinion. a case of granulomatous perioral dermatitis. I avoid arguing differences of opinion in Letters to the Editor since little is usually settled in matters of personal personal preference. However, in this situation I must respond because of my concern regarding proper patient management.The patients described by Frieden and coworkers and Gupta and coworkers are not unique or exceptionally rare. We have seen a further six cases that we did not describe in our centerfold article since it was suitable for only a single-patient presentation. Between the two series of 11 patients, nine have been black and their ages have ranged from 2 to 12 years. Pustules have not been a prominent feature of any of these eruptions and, although Frieden and