Early-onset childhood sarcoidosis is a unique form of the disease characterized by the triad of rash, uveitis, and arthritis in patients presenting before age 4 years. We report a case of early onset childhood sarcoidosis in a 4-year-old girl. She presented with fever, right ankle joint swelling, multiple skin lesions on whole body and was diagnosed as juvenile rheumatoid arthritis in Department of Pediatrics. She was transferred to Department of Dermatology for skin evaluation, histological investigation revealed well-circumscribed, non-caseating naked granuloma with epitheloid cells, histiocytes, lymphocytes on the upper dermis. Laboratory evaluation, chest X-ray, and ophthalmologic evaluation were all within normal limits. She was treated with systemic steroid, methotrexate, non-steroidal anti-inflammatory drugs and follow up evaluation will be planned for possible eye involvement. (Korean J Dermatol 2000;38(12): 1696-1698)