The answer to the NEJM challenge is #2. Angiotensin Converting Enzyme.Lupus pernio is a skin manifestation of sarcoidosis that involves the nasal bridge and cheeks. Serum levels of the angiotensin-converting enzyme are elevated in the majority of patients with untreated sarcoidosis.Sarcoidosis is an autoimmune disease that causes inflammatory cells to clump in various parts of the body, commonly
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