Sarcoidosis masquerading as a dermatological problem presenting a diagnostic challenge in an aviator – A case report

A 36 year old IAF pilot presented with a two years history of recurrent nodules and plaques on his back, shoulder, and face. Skin biopsy showed diffuse non-necrotizing granulomatous lesion infiltrated with numerous multinucleated giant cell and lymphocytes. Missed diagnosis of cutaneous tuberculosis and later leprosy was made for which he received antituberculous and antilepromatous drugs. A repeat skin biopsy upon recurrence of skin lesion in the presence of bilateral hilar lymphadenopathy led to the diagnosis of sarcoidosis. He was treated with oral steroids with which his lesions regressed. Diagnostic challenges faced in a case of cutaneous sarcoidosis and its associated aeromedical concerns will be discussed.