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Sarcoidosis — SCE Dermatology MCQ

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HardConnective Tissue & VasculitisSarcoidosisSCE Dermatology

A 35-year-old man presents with a persistent erythematous plaque on his nose. Dermoscopy shows orange structureless areas (so-called 'apple jelly' nodules) with linear branching vessels. Biopsy shows non-caseating granulomas. What is the diagnosis?

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Correct answer: B — Lupus pernio (cutaneous sarcoidosis of the nose)

The best answer is “Lupus pernio (cutaneous sarcoidosis of the nose)”. Dermatological surgery should preserve diagnostic architecture, orient closure with local tension and cosmetic units, and select reconstruction by defect depth, size, subunit and functional distortion risk. The alternatives “Basal cell carcinoma, after clinicopathological correlation”, “Rhinophyma, after specialist assessment, when the full phenotype supports it”, “Rosacea, when the full phenotype supports it”, “Lupus vulgaris, within an appropriate UK pathway” are clinically adjacent possibilities, but they do not fit the defining morphology, distribution, histopathology, risk signal or management sequence in this stem.

Reference: NICE HTG388 melanoma diagnostic practice: https://www.nice.org.uk/guidance/htg388/chapter/3-Clinical-need-and-practice