Sarcoidal reaction to lymphoma presenting as granulomatous rosacea

A patient with poorly differentiated lymphocytic lymphoma had rosacealike facial lesions noted at the time of diagnosis of the lymphoma. The skin lesions followed the course of exacerbations and remissions of the systemic lymphoma. A biopsy specimen showed a sarcoidal granulomatous inflammation in the skin, and later in subcutaneous nodules that developed on the face. This case is consistent with a sarcoidal tissue reaction to lymphoma, and is unique in its clinical presentation as granulomatous rosacea.