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A 43-year-old African American man presents with a 1-year history of recalcitrant lesions to his face. He has previously tried and failed various over the counter and prescription acne treatments, including oral trimethoprim-sulfamethoxazole. He reports new-onset fatigue, joint pains, and occasional blurry vision.

Given the patient’s cutaneous physical exam findings, what is the most likely diagnosis?
A. Cutaneous lupus
B. Molluscum contagiosum
C. Orificial tuberculosis
D. Rosacea
E. Sarcoidosis

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