Micropapular Cutaneous Sarcoidosis Confined to the Face: An Uncommon Clinical Variant

TL;DR

A rare facial skin condition called micropapular sarcoidosis was successfully treated with corticosteroids and hydroxychloroquine.

Contribution

This paper presents a new clinical case of micropapular sarcoidosis confined to the face and its effective treatment.

Findings

The patient showed gradual improvement with oral corticosteroids, hydroxychloroquine, and topical steroids.

Skin biopsy confirmed noncaseating epithelioid granulomas consistent with cutaneous sarcoidosis.

The case highlights the importance of considering this rare variant in facial papular eruptions.

Abstract

Micropapular sarcoidosis represents an uncommon variant of cutaneous sarcoidosis, typically presenting with a sudden onset, often resolving without residual scarring, and generally favorable prognosis. Its resemblance to other chronic papular dermatoses makes diagnosis challenging, especially in cases with subtle or localized cutaneous manifestations. We report a case of a 36-year-old female who presented with gradually progressive, asymptomatic skin-colored, and erythematous papules localized to the periorbital and perioral regions over six months. Systemic symptoms were absent, and routine blood investigations revealed anemia and elevated erythrocyte sedimentation rate (ESR). Skin biopsy revealed noncaseating epithelioid granulomas with lymphocytes suggestive of cutaneous sarcoidosis. The patient responded well to a combination of oral corticosteroids, hydroxychloroquine, and topical corticosteroids, with near-complete resolution of lesions and residual post-inflammatory hyperpigmentation over a period of three months. This case emphasizes the importance of considering micropapular sarcoidosis in the differential diagnosis of chronic facial papular eruptions and highlights the effectiveness of early appropriate treatment.

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