Sarcoidosis can involve almost any organ system. Up to one-third of patients with systemic sarcoid have cutaneous manifestations. These specific lesions encompass a wide range of morphologies, including papules, plaques, subcutaneous tumors, ulcers, ichthyosis, and lupus pernio. Lupus pernio typically presents as violaceous, smooth plaques involving the nose, cheeks, lips, forehead, ears, or distal extremities. We describe a 36 year old woman from Honduras with a progressive nasal deformity of several years duration. The bulbous, symmetric enlargement of the nose extended from the nasal tip to the bridge with erythema, papulonodular lesions and pustules, simulating rhinophyma. Examination of the internal nares revealed complete destruction of the nasal septum. All surfaces of the neck, upper trunk, proximal upper extremities and, to a lesser degree, the periorbital skin showed densely crowded light brown papules ranging from 1–3 mm in diameter. Multiple nasal biopsies of skin and mucosa showed non-caseating granulomas, consistent with sarcoidosis. By contrast, histology of the papular eruption on the trunk was diagnostic of syringoma. Sarcoidosis masquerading as rhinophyma has been rarely described in the literature, and to our knowledge, this is the first case associated with eruptive syringoma. This report underscores the need to consider lupus pernio in the differential diagnosis of rhinophyma.