A Case of Atypical Presentation of Morpheaform Verrucous Sarcoidosis

Morpheaform verrucous sarcoidosis is a rare variation of cutaneous sarcoidosis that is characterized by prominent, localized keratotic plaques on the skin. The etiology of this condition is unknown, and the current literature is limited. Sarcoidosis is typically a systemic condition with high incidence in the African-American population, and cutaneous presentation without systemic manifestation is exceedingly rare. This report details the challenging identification of this condition given the patient's history of multiple concurrent autoimmune and inflammatory conditions. Only nine cases of morpheaform sarcoidosis have been reported in the literature. This case demonstrates the complexity of diagnosing cutaneous sarcoidosis if the clinical systemic symptoms have not yet fully developed. It is important to take a multi-disciplinary approach with dermatology, rheumatology, and pulmonology to arrive at the correct diagnosis as cutaneous lesions can mimic several different cutaneous dermatoses. Therefore, physicians should consider morpheaform sarcoidosis on the differential in patients who present with indurated and eroded verruciform plaques.