Micropapular sarcoidosis: A diagnostic dilemma

Sarcoidosis is a multisystem disorder of unknown etiology. 25%–30% of patients with systemic sarcoidosis have cutaneous involvement. Sarcoidosis is called a great imitator due to its varied clinical presentation. Micropapular sarcoidosis is a rare morphological type of cutaneous sarcoidosis that rarely has systemic involvement. A case of a middle-aged man who presented with multiple tiny papules all over the back, shoulders and arms was discussed. He was initially diagnosed to have leprosy and treated with multibacillary multidrug therapy. Histopathology showed noncaseating epithelioid granuloma in upper dermis. On the basis of clinical, demographic, and histopathological findings, a diagnosis of cutaneous micropapular sarcoidosis was made. The patient was treated with systemic steroids tapered over 3 months, following which the lesions resolved completely. There are very few reports of micropapular sarcoidosis available in the literature.