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Dermatology — UKMLA MCQ

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HardDermatologyUKMLAMRCP Part 1

A patient has tender erythematous shin nodules, ankle arthritis, cough and bilateral hilar lymphadenopathy. Which underlying diagnosis best unifies the presentation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Sarcoidosis presenting as Lofgren syndrome

The best answer is “Sarcoidosis presenting as Lofgren syndrome”. Erythema nodosum, bilateral hilar lymphadenopathy and acute ankle periarthritis form the classic Lofgren presentation of sarcoidosis. Behcet disease features oral and genital ulcers, GPA causes destructive airway and renal disease, rheumatoid nodules occur in established seropositive disease, and systemic sclerosis does not explain hilar adenopathy.

Reference: British Thoracic Society: Clinical statement on pulmonary sarcoidosis: https://thorax.bmj.com/content/76/1/4