A 39 year-old woman presented with this nodular rash.
A chest X-ray was obtained and hilar lymphadenopathy was discovered. This is Lӧfren Syndrome, which is the manifestation of Sarcoidosis which includes erythema nodosum, hilar adenopathy, and arthritis. With this very specific presentation, a diagnosis of Sarcoidosis can be made without a biopsy. Fortunately, this form of Sarcoidosis has an excellent prognosis and can be managed with NSAIDs.
See more cases like this on Figure 1.