Sarcoidosis is a multisystem granulomatous disorder characterized by non-caseating epithelioid granulomas, with pulmonary involvement being the most common manifestation. Cutaneous sarcoidosis occurs in approximately 20–35% of patients and exhibits a wide spectrum of morphologies, often mimicking other dermatoses. Psoriasiform sarcoidosis is an exceptionally rare variant and poses a significant diagnostic challenge. We report a 78-year-old female who presented with painful, pruritic erythematous scaly plaques involving the face, upper limbs, lower limbs, and upper back for 4 years, with recent worsening. Laboratory evaluation revealed elevated serum angiotensin-converting enzyme levels. Contrast-enhanced computed tomography demonstrated pulmonary nodules with interstitial changes and nodules in the liver and spleen. Histopathology of a skin biopsy showed well-formed non-caseating epithelioid granulomas with Langhans giant cells, confirming the diagnosis of cutaneous sarcoidosis. The patient was treated with hydroxychloroquine and mycophenolate mofetil, resulting in significant clinical improvement. Psoriasiform sarcoidosis is a rare clinical mimic of chronic plaque psoriasis. Persistent psoriasiform lesions, particularly in elderly patients and those unresponsive to conventional therapy, should prompt histopathological evaluation and systemic workup for early diagnosis and appropriate management.
Azhikoden et al. (Mon,) studied this question.