Micropapular Sarcoidosis Simulating Lichen nitidus

Abstract

A 28-year-old woman with sarcoidosis had miliary, skin-colored papules localized on the upper back. The lesions closely simulated lichen nitidus. Histologic examination of the papule demonstrated the naked granuloma encircled by epidermal collarettes in the papillary dermis. Therefore, the microscopic reaction pattern also resembled those of lichen nitidus. This case is a unique form of micropapular sarcoidosis in respect to the clinical appearance and microscopic changes.

Sarcoidosis: Are there differences in your skin of color patients?

“…Many additional clinical presentations of chronic cutaneous sarcoidal lesions have been reported. 5 Some of these presentations, not previously discussed, include morpheaform plaques, 61 lower extremity swelling, 62 lichen niditus-like papules, 63 verrucous lesions, 26 and pustular lesions, 26 to name a few. Sarcoid lesions may also develop in areas of exogenous ochronosis in patients with systemic sarcoidosis.…”

Multiple skin-coloured papules in a child

“…Micropapular sarcoidosis is a very rare morphological manifestation of sarcoidosis, also described as ‘lichen nitidus‐like sarcoidosis’ 6 . It has an acute onset and good prognosis without scarring 3 .…”

“…5 Micropapular sarcoidosis is a very rare morphological manifestation of sarcoidosis, also described as Ôlichen nitidus-like sarcoidosisÕ. 6 It has an acute onset and good prognosis without scarring. 3 Systemic involvement in this disorder, such as progressive lung disease, is less common than in other forms of cutaneous sarcoidosis, but ocular involvement is relatively frequent.…”

Crohn's Disease and Lichen Nitidus: A Case Report and Comparison of Common Histopathologic Features

“…In particular, 1) if minute purpuric papules are present on the hands, lichen nitidus can be confused with dyshidrotic eczema; 2) if minute keratotic papules are present on the body, it can be confused with follicular eczema; and 3) if confluent hyperkeratotic papules are present on the palms, it can be resemble chronic fissured eczema. Under a variety of conditions, lichen nitidus may also resemble lichen scrofulosorum, lichenoid syphilitic lesions, bowenoid papulosis, lichen amyloid (24), and cutaneous sarcoid (40), which itself resembles “metastatic” CD.…”