Pigmentary Puzzle: A Rare Case of Hyperpigmented Cutaneous Sarcoidosis

A 13-year-old male presented with a rare variant of hyperpigmented cutaneous sarcoidosis, characterized by insidious onset hyperpigmentation over the face, trunk, and upper limbs. Histopathological examination revealed non-caseating epithelioid cell granulomas, confirming sarcoidosis despite normal serum calcium and ACE levels. This case underscores the diagnostic challenge of rare cutaneous sarcoidosis variants, which can mimic other conditions and may be underreported without frequent biopsies. Early detection and biopsy confirmation are crucial for accurate diagnosis and treatment, improving patient outcomes. This is the first reported case of this specific presentation.