Systemic sarcoidosis with lung and cutaneous lesions

A 28 year-old woman presented to our clinic for subungueal hyperkeratotic lesion of the fourth left toenail. In 1997, she developed systemic sarcoidosis with lung and cutaneous lesions. The patient required gradually tapered systemic corticosteroids for 4 years and methotrexate for 1 year to control lung disease. What is your diagnosis?

image

  1. Lupoid dystrophy
  2. Cystic bone change
  3. Eosinophilic granuloma of the nail
  4. Sarcoidosis dystrophy