Lupus pernio is the pathognomonic skin lesion of sarcoidosis. Its histological description is:

• A Caseating granuloma with Langhans giant cells
• B Lichenoid infiltrate with basal cell vacuolation
• C Neutrophilic infiltrate with leukocytoclasis
• D Non-caseating epithelioid granuloma with a sparse lymphocyte rim ('naked granuloma') ✓

Explanation

Sarcoid granulomas are characteristically non-caseating, composed of compact epithelioid histiocytes with a sparse surrounding lymphocytic cuff—the 'naked granuloma'. Giant cells may contain asteroid bodies (stellate eosinophilic inclusions) or Schaumann bodies (calcified concentric lamellae). Caseating granulomas suggest tuberculosis; lichenoid infiltrate is seen in lichen planus and DLE; leukocytoclastic infiltrate is the hallmark of cutaneous vasculitis.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.