Copper-induced cutaneous sarcoidosis.

A 52-year-old woman presented with gradual painless enlargement of both earlobes. Indurated plaques were also present elsewhere. There was no evidence of a systemic granulomatous disorder. Histopathology showed foreign material associated with granulomatous inflammation. Scanning electron microscopy and energy-dispersive analysis of X-rays demonstrated foreign material composed primarily of copper. Deposition is likely to have been related to corrosion of copper-containing earrings, or from deposition at the time of ear piercing. The presence of clinically similar granulomatous lesions remote from the earlobes and not containing copper suggest the presence of underlying cutaneous sarcoidosis. The earlobe lesions are more likely to be caused by foreign matter acting non-specifically as a nidus for cutaneous sarcoidosis, rather than by a specific pro-inflammatory effect of dermal copper. After 3 months, the lesions have partially responded to oral hydroxychloroquine 200 mg/day.