Can granuloma annulare evolve into cutaneous sarcoidosis?

We report the unique case of a 50-year-old African American female with pul monary sarcoidosis who presented with a new ichthyosiform eruption symmetri cally located on the anterior shins and surrounded by red, translucent, int radermal papules. A skin biopsy of a new red papule showed features consist ent with granuloma annulare (GA) with positive mucin staining, and an older hyperpigmented papule showed classic dermal noncaseating granulomas consis tent with sarcoidosis. Recent reports have clearly demonstrated GA occurring in association with s arcoidosis, but this is the first report that suggests that a GA lesion may develop into a sarcoidal granuloma. We propose that GA may act as a precur sor lesion to the more mature sarcoidal granuloma. This case further unders cores the importance of careful clinicopathologic correlation.