Cutaneous sarcoidosis during rituximab treatment for microscopic polyangiitis: an uncommon adverse effect?

Scar sarcoidosis following rituximab therapy

“…The temporal onset of scar sarcoidosis shortly following rituximab therapy, with spontaneous resolution starting 10 months after the rituximab course was completed, supports that the initiating trigger was rituximab, adding to the literature describing this uncommon adverse effect. [8][9][10] As with other cases of scar sarcoidosis reported in the literature, unrelated to rituximab, 16 her surgical scar was spared.…”

“…The majority of the reported patients who developed sarcoidosis after treatment for lymphoma with a regimen that included rituximab did not have skin involvement, and the disease was mild or even self-healing as with the other nonlymphoma cases of rituximab-induced sarcoidosis. [8][9][10] This is in contrast with the reported cases of scar sarcoidosis where The relatively short-time interval to observed scar fullness 2 months following rituximab therapy, with diagnosis of sarcoidosis at 6 months posttreatment, may be in part due to concomitant underlying immune dysregulation caused by chronic GVHD. The temporal onset of scar sarcoidosis shortly following rituximab therapy, with spontaneous resolution starting 10 months after the rituximab course was completed, supports that the initiating trigger was rituximab, adding to the literature describing this uncommon adverse effect.…”

“…To date, the literature is very limited on patients with a clear causal timeline of development of sarcoidosis from rituximab (Table 1). The majority of the reported patients who developed sarcoidosis after treatment for lymphoma with a regimen that included rituximab did not have skin involvement, and the disease was mild or even self‐healing as with the other nonlymphoma cases of rituximab‐induced sarcoidosis 8‐10 . This is in contrast with the reported cases of scar sarcoidosis where over 70% of the cases (8/11) had stage 2 or 3 lung disease 2 .…”

“…Rituximab has been shown to be efficacious in chronic graft vs host disease (GVHD), 5 as well as other inflammatory conditions that are primarily T‐cell driven, leading to its increased use in these cases, including sarcoidosis 6 . Similarly to the paradoxical relationship between anti‐TNF‐α treatment of sarcoidosis and its association with the development of sarcoidosis, there are an increasing number of reports of sarcoidosis following rituximab therapy for lymphoma 7 and inflammatory diseases 8‐10 . Herein, we describe a case of sarcoidosis with cutaneous involvement of traumatic scars following rituximab therapy and review the literature for similarly reported cases.…”

“…6 Similarly to the paradoxical relationship between anti-TNF-α treatment of sarcoidosis and its association with the development of sarcoidosis, there are an increasing number of reports of sarcoidosis following rituximab therapy for lymphoma 7 and inflammatory diseases. [8][9][10] Herein, we describe a case of sarcoidosis with cutaneous involvement of traumatic scars following rituximab therapy and review the literature for similarly reported cases.…”