<prompt> A young lady presented with bilateral nodular lesions on shins. She was also found to have bilateral hilar lymphadenopathy on chest X-ray. Mantoux test reveals indurations of 5 mms. A skin biopsy would reveal -Non caseating GranulomaVasculitisCaseating GranulomaMalignant cells  <response>: Skin lesions in this patient is Erythema nodosum.Erythema nodosum, bilateral hilar lymphadenopathy negative Mantoux test is strongly suggestive of sarcoidosis.Skin biopsy or biopsy from hilar nodes, conjunctiva, lip, or spleen, intraabdominal nodes would reveal non-caseating granulomas.Signs and symptoms of sarcoidosisAny organ system of the body can be involved. However, lungs with lymph nodes, skin and eye are the three most common sites involved in sarcoidosis.I. Lungs with lymph nodes 95Respiratory complaints including a cough and dyspnea are the most common presenting symptoms.Usually, the infiltrate in sarcoidosis are predominantly an upper lobe process.There is bilateral hilar lymphadenopathy.II. Skin 24-43Erythema nodosumMaculopapular lesionsHyper-or hypopigmentationKeloid formation and subcutaneous nodulesLupus pernio Involvement of the bridge of the nose, the area beneath the eyes and cheek. It is diagnostic for a chronic form of sarcoidosis.Lofgrens syndrome Erythema nodosum with hilar adenopathy and uveitis.III. Eye 12-29Uveitis Cause Photophobia, blurred vision, increased tearingRetinitis Cause Photophobia, blurred vision, increased tearingPars plastic Cause Photophobia, blurred vision, increased tearingIV Non-specific constitutional symptoms are fatigue most common, fever, night sweat and weight loss. Other organssystems involved areLiver Spleen Endocrine Granuloma can secret 1-25 OH2 Vit D which causes hypercalcemia.Uveoparotid fever Uveitis parotitis VII nerve palsy, it is associated with Heerfordt - waldenstrom syndrome.Parotid glands HeartBrain Neurosarcoidosis 