Improving cosmesis of lupus pernio by excision and forehead flap reconstruction

Sarcoidosis is a granulomatous multiorgan disease that frequently affects the skin. Lupus pernio (LP) is a cutaneous presentation resulting in violaceous discolouration and swelling of the nose. We report a severe case resistant to conventional treatment, which ultimately underwent nasal resurfacing by forehead flap rhinoplasty. Flap reconstruction has not previously been reported for deforming LP. We review the long-term outcome and advocate consideration of plastic surgery input in severe disease resistant to medical treatments.