External Genital Cutaneous Sarcoidosis Mimicking Lichen Sclerosus

Although external genital cutaneous sarcoidosis is rare, it can closely resemble lichen sclerosus (LS) and delay diagnosis. We report a case of a 69-year-old woman with long-standing vulvar symptoms and LS-like pallor of the labia minora and clitoris. Biopsy showed non-caseating granulomas with negative infection stains, consistent with vulvar sarcoidosis. This case supports the need for early biopsy in cases of persistent or atypical vulvar pallor and highlights sarcoidosis as an uncommon but important LS-mimic.