An unusual presentation of sarcoidosis: The great mimicker

Sarcoidosis is a very well-known disease for its variable clinical and radiological presentation. Thoracic involvement is the commonest manifestation of sarcoidosis followed by skin. We present here an interesting case report of an old-age patient with an unusual presentation of sarcoidosis. He was previously treated for leprosy based on skin biopsy with partial relief only. The unusual things in this patient were clinical and radiological findings. Clinically, he had only complaints of weight loss which had not been reported earlier; second, the skin lesions were not typical. The unusual radiological things were a disproportionate distribution of radiological lesions and predominant consolidation. Lower lobe consolidation in sarcoidosis is rarely reported, which was present in this patient. The perilymphatic micronodules were more concentrated on the right upper lobe as compared to the left upper lobes. Based on this case report we cannot deny the wrong diagnosis of leprosy because both diseases share common clinical and histopathological features.