This 5-year-old girl developed a non-pruritic scaly maculopapular eruption on her upper extremities one year prior to presentation. The eruption later spread to her legs and abdomen. During this time, she also had a persistent cough and swelling of the right index finger. The histopathology is typical for sarcoidosis with nekked, epithelioid noncaseating granulomas. The histologic differential diagnosis would include infectious processes.
At higher power of the same lesion, histiocytes aggregate into well-formed tight noncaseating granulomas. Multinucleated Langhans-type giant cells are present with a possible early intracytoplasmic asteroid body (center of field). The background is almost devoid of lymphocytes.