Key point: In this demographic group, asymptomatic erythematous papules on the nose or around the eyes or mouth should suggest sarcoidosis. A small biopsy demonstrated noncaseating granulomata, consistent this diagnosis. A chest radiograph demonstrated bilateral hilar adenopathy without parenchymal involvement.
Treatment: Because of the limited extent of disease, intralesional injections of dilute (5 mg/mL) triamcinolone acetonide were used to eliminate the skin lesions.
Note: An alternative treatment might be application of an ultrapotent corticosteroid preparation. If those maneuvers failed, an oral antimalarial medication (such as hydroxycholorquine) would be the next intervention.