Abstract
Sarcoidosis is a multisystemic granulomatous disease of unknown cause that most commonly involves not only the lungs but also the skin (around one-third of cases). Clinical forms include popular or plaque types, nodular types, erythema nodosum, scar sarcoidosis, and other miscellaneous forms. Topical treatment mainly consists of potent topical corticosteroids. In case of organ involvement, especially pulmonary, neural, liver, renal, ocular or cardiac involvement, and symptoms such as persistent fever, weight loss, or when hypercalcemia occurs, systemic treatment should be considered.
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References
Agbogu BN, et al. Therapeutic considerations in patients with refractory neurosarcoidosis. Arch Neurol. 1995;52(9):875–9.
Bachelez H, et al. The use of tetracyclines for the treatment of sarcoidosis. Arch Dermatol. 2001;137(1):69–73.
Backer H, Landthaler M, Szeimies RM. Therapeutic strategies for cutaneous sarcoidosis. J Dtsch Dermatol Ges. 2005;3(4):284–97; quiz 298–300.
Baughman RP, Lower EE. Leflunomide for chronic sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2004;21(1):43–8.
Baughman RP, Lower EE. Evidence-based therapy for cutaneous sarcoidosis. Clin Dermatol. 2007;25(3):334–40.
Baughman RP, Winget DB, Lower EE. Methotrexate is steroid sparing in acute sarcoidosis: results of a double blind, randomized trial. Sarcoidosis Vasc Diffuse Lung Dis. 2000;17(1):60–6.
Baughman RP, et al. Thalidomide for chronic sarcoidosis. Chest. 2002;122(1):227–32.
Baughman RP, et al. Etanercept for refractory ocular sarcoidosis: results of a double-blind randomized trial. Chest. 2005;128(2):1062–47.
Baughman RP, et al. Presenting characteristics as predictors of duration of treatment in sarcoidosis. QJM. 2006a;99(5):307–15.
Baughman RP, et al. Infliximab therapy in patients with chronic sarcoidosis and pulmonary involvement. Am J Respir Crit Care Med. 2006b;174(7):795–802.
Bhat P, et al. Mycophenolate mofetil therapy for sarcoidosis-associated uveitis. Ocul Immunol Inflamm. 2009;17(3):185–90.
Brechtel B, et al. Allopurinol: a therapeutic alternative for disseminated cutaneous sarcoidosis. Br J Dermatol. 1996;135(2):307–9.
Breuer K, et al. Therapy of noninfectious granulomatous skin diseases with fumaric acid esters. Br J Dermatol. 2005;152(6):1290–5.
Burns AM, Green PJ, Pasternak S. Etanercept-induced cutaneous and pulmonary sarcoid-like granulomas resolving with adalimumab. J Cutan Pathol. 2012;39(2):289–93.
Chaussenot A, et al. Neurosarcoidosis treated with mycophenolate mofetil: two cases. Rev Neurol (Paris). 2007;163(4):471–5.
Chong WS, Tan HH, Tan SH. Cutaneous sarcoidosis in Asians: a report of 25 patients from Singapore. Clin Exp Dermatol. 2005;30(2):120–4.
Crouser ED, et al. Diagnosis and detection of sarcoidosis. An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2020;201(8):e26–51.
Demeter SL. Myocardial sarcoidosis unresponsive to steroids. Treatment with cyclophosphamide. Chest. 1988;94(1):202–3.
Denys BG, et al. Steroid-resistant sarcoidosis: is antagonism of TNF-alpha the answer? Clin Sci (Lond). 2007;112(5):281–9.
Doherty CB, Rosen T. Evidence-based therapy for cutaneous sarcoidosis. Drugs. 2008;68(10):1361–83.
Doty JD, Mazur JE, Judson MA. Treatment of sarcoidosis with infliximab. Chest. 2005;127(3):1064–71.
Drake WP, et al. Oral antimycobacterial therapy in chronic cutaneous sarcoidosis: a randomized, single-masked, placebo-controlled study. JAMA Dermatol. 2013;149(9):1040–9.
Fazzi P, et al. Thalidomide for improving cutaneous and pulmonary sarcoidosis in patients resistant or with contraindications to corticosteroids. Biomed Pharmacother. 2012;66(4):300–7.
Field S, et al. Recalcitrant cutaneous sarcoidosis responding to adalimumab but not to etanercept. Clin Exp Dermatol. 2010;35(7):795–6.
Flaherty KR, et al. Nintedanib in progressive Fibrosing interstitial lung diseases. N Engl J Med. 2019;381(18):1718–27.
Gerke AK. Treatment of sarcoidosis: a multidisciplinary approach. Front Immunol. 2020;11:545413.
Gutzmer R, Kapp A, Werfel T. Successful treatment of skin and lung sarcoidosis with fumaric acid ester. Hautarzt. 2004;55(6):553–7.
Haimovic A, et al. Sarcoidosis: a comprehensive review and update for the dermatologist: part I. Cutaneous disease. J Am Acad Dermatol. 2012;66(5):699 e1–18; quiz 717-8.
Henderson CA, Ilchyshyn A, Curry AR. Laryngeal and cutaneous sarcoidosis treated with methotrexate. J R Soc Med. 1994;87(10):632–3.
Hirsch JG. Experimental treatment with chloroquine. Am Rev Respir Dis. 1961;84(5)Pt 2:52–8.
Jones E, Callen JP. Hydroxychloroquine is effective therapy for control of cutaneous sarcoidal granulomas. J Am Acad Dermatol. 1990;23(3 Pt 1):487–9.
Jung YJ, Roh MR. Clinical and histopathological analysis of specific lesions of cutaneous sarcoidosis in Korean patients. J Dermatolog Treat. 2011;22(1):11–7.
Klein A, et al. Off-label use of fumarate therapy for granulomatous and inflammatory skin diseases other than psoriasis vulgaris: a retrospective study. J Eur Acad Dermatol Venereol. 2012;26(11):1400–6.
Kouba DJ, et al. Mycophenolate mofetil may serve as a steroid-sparing agent for sarcoidosis. Br J Dermatol. 2003;148(1):147–8.
Lower EE, Baughman RP. The use of low dose methotrexate in refractory sarcoidosis. Am J Med Sci. 1990;299(3):153–7.
Lower EE, Baughman RP. Prolonged use of methotrexate for sarcoidosis. Arch Intern Med. 1995;155(8):846–51.
Marchell RM, Judson MA. Cutaneous sarcoidosis. Semin Respir Crit Care Med. 2010;31(4):442–51.
Martinet Y, et al. Evaluation of the in vitro and in vivo effects of cyclosporine on the lung T-lymphocyte alveolitis of active pulmonary sarcoidosis. Am Rev Respir Dis. 1988;138(5):1242–8.
Meissner M, et al. Dimethyl fumarate—only an anti-psoriatic medication? J Dtsch Dermatol Ges. 2012;10(11):793–801.
Milman N, et al. No effect of high-dose inhaled steroids in pulmonary sarcoidosis: a double-blind, placebo-controlled study. J Intern Med. 1994;236(3):285–90.
Miyazaki E, et al. Minocycline for the treatment of sarcoidosis: is the mechanism of action immunomodulating or antimicrobial effect? Clin Rheumatol. 2008;27(9):1195–7.
Morimatsu Y, et al. Remarkable improvement in clinical course and serum KL-6 levels after initiation of high-dose inhaled budesonide in pulmonary sarcoidosis. Kurume Med J. 2020;66(1):71–5.
Morse SI, et al. The treatment of sarcoidosis with chloroquine. Am J Med. 1961;30:779–84.
Moudgil A, Przygodzki RM, Kher KK. Successful steroid-sparing treatment of renal limited sarcoidosis with mycophenolate mofetil. Pediatr Nephrol. 2006;21(2):281–5.
Muller-Quernheim J, et al. Treatment of chronic sarcoidosis with an azathioprine/prednisolone regimen. Eur Respir J. 1999;14(5):1117–22.
Nguyen YT, et al. Treatment of cutaneous sarcoidosis with thalidomide. J Am Acad Dermatol. 2004;50(2):235–41.
Nowack U, et al. Successful treatment of recalcitrant cutaneous sarcoidosis with fumaric acid esters. BMC Dermatol. 2002;2:15.
Oswald-Richter KA, et al. Dual analysis for mycobacteria and propionibacteria in sarcoidosis BAL. J Clin Immunol. 2012;32(5):1129–40.
Pariser RJ, et al. A double-blind, randomized, placebo-controlled trial of adalimumab in the treatment of cutaneous sarcoidosis. J Am Acad Dermatol. 2013;68(5):765–73.
Pia G, et al. Evaluation of the efficacy and toxicity of the cyclosporine A-flucortolone-methotrexate combination in the treatment of sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 1996;13(2):146–52.
Prasse A. The diagnosis, differential diagnosis, and treatment of sarcoidosis. Dtsch Arztebl Int. 2016;113(33–34):565–74.
Rosof BM. Letter: allopurinol for sarcoid? N Engl J Med. 1976;294(8):447.
Schmitt CE, et al. Hypopigmented cutaneous sarcoidosis responsive to minocycline. J Drugs Dermatol. 2012;11(3):385–9.
Siltzbach LE, Teirstein AS. Chloroquine therapy in 43 patients with intrathoracic and cutaneous sarcoidosis. Acta Med Scand Suppl. 1964;425:302–8.
Stagaki E, et al. The treatment of lupus pernio: results of 116 treatment courses in 54 patients. Chest. 2009;135(2):468–76.
Steen T, English JC. Oral minocycline in treatment of cutaneous sarcoidosis. JAMA Dermatol. 2013;149(6):758–60.
Sweiss NJ, et al. Efficacy results of a 52-week trial of adalimumab in the treatment of refractory sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis. 2014a;31(1):46–54.
Sweiss NJ, et al. Rituximab in the treatment of refractory pulmonary sarcoidosis. Eur Respir J. 2014b;43(5):1525–8.
Thielen AM, et al. Refractory chronic cutaneous sarcoidosis responsive to dose escalation of TNF-alpha antagonists. Dermatology. 2009;219(1):59–62.
Tuchinda C, Wong HK. Etanercept for chronic progressive cutaneous sarcoidosis. J Drugs Dermatol. 2006;5(6):538–40.
Ungprasert P, Ryu JH, Matteson EL. Clinical manifestations, diagnosis, and treatment of sarcoidosis. Mayo Clin Proc Innov Qual Outcomes. 2019;3(3):358–75.
Utz JP, et al. Etanercept for the treatment of stage II and III progressive pulmonary sarcoidosis. Chest. 2003;124(1):177–85.
Valeyre D, et al. Sarcoidosis. Lancet. 2014;383(9923):1155–67.
Veien NK, Brodthagen H. Cutaneous sarcoidosis treated with methotrexate. Br J Dermatol. 1977;97(2):213–6.
Voelter-Mahlknecht S, et al. Treatment of subcutaneous sarcoidosis with allopurinol. Arch Dermatol. 1999;135(12):1560–1.
Waldinger TP, et al. Treatment of cutaneous sarcoidosis with isotretinoin. Arch Dermatol. 1983;119(12):1003–5.
Wanat KA, Rosenbach M. Case series demonstrating improvement in chronic cutaneous sarcoidosis following treatment with TNF inhibitors. Arch Dermatol. 2012;148(9):1097–100.
Webster GF, et al. Weekly low-dose methotrexate therapy for cutaneous sarcoidosis. J Am Acad Dermatol. 1991;24(3):451–4.
Wyser CP, et al. Treatment of progressive pulmonary sarcoidosis with cyclosporin a. a randomized controlled trial. Am J Respir Crit Care Med. 1997;156(5):1371–6.
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Quist, S. (2023). Sarcoidosis. In: Katsambas, A.D., Lotti, T.M., Dessinioti, C., D'Erme, A.M. (eds) European Handbook of Dermatological Treatments. Springer, Cham. https://doi.org/10.1007/978-3-031-15130-9_84
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