History:

A 34 year-old Black male presented with multiple, indurated plaques on both upper arms and both forearms. The lesions were notable for a rim of distinct hypopigmentation. The patient denied any other symptoms, and a recent routine laboratory panel was unremarkable. Biopsy revealed "naked granulomas" most characteristic of sarcoidosis. A chest x-ray disclosed bilatera; hilar adenopathy, and a seum ACE level was 30% above the upper level of normal. He was treated, successfully, with hydroxychloroquine. He remains on suppressive antimalarial therapy.