GIANT-CELL LICHENOID DERMATITIS - A POSSIBLE MANIFESTATION OF SARCOIDOSIS

Giant cell lichenoid dermatitis is a recently described dermatosis tho ught to be an unusual lichenoid drug eruption. It is characterized by a generalized, pruritic, papulosquamous eruption sparing palms, soles, face and mucous membranes. Histopathologic findings include areas of epidermal hyperplasia and atrophy with focal vacuolar alteration of th e basal layer, exocytosis and cytoid body formation. The dermis contai ns a band-like, mononuclear cell infiltrate at the dermoepidermal junc tion with admixed eosinophils, plasma cells and large multinucleate ce lls. The histologic differential diagnosis includes infectious process es, sarcoidosis, lichen nitidus, lupus erythematosus and lichen planus . We report 3 patients with giant cell lichenoid dermatitis, one of wh om was subsequently diagnosed as having sarcoidosis. Because giant cel l lichenoid dermatitis may resemble sarcoidosis both clinically and hi stologically, and because cutaneous sarcoid is often associated with s ystemic involvement, the diagnosis of sarcoid should be strongly consi dered in patients with giant cell lichenoid dermatitis.