Treatment of cutaneous sarcoidosis with isotretinoin

Abstract

A patient with chronic cutaneous and pulmonary sarcoidosis, unresponsive to oral corticosteroid therapy, was treated with isotretinoin. The patient's cutaneous manifestations of sarcoidosis showed consistent improvement during the course of retinoid therapy. The lesions that responded earliest either resolved or showed the greatest reduction in size. The patient's WBC count increased and her angiotensin-converting enzyme level decreased during the first two months of isotretinoin therapy; both returned to pretreatment levels during the third month of therapy. Pulmonary function tests were unchanged after four months of treatment. Isotretinoin may be a useful therapeutic agent for cutaneous sarcoidosis. However, the possibility of spontaneous remission of the disease during the course of therapy cannot be excluded.

New Indications and New Retinoids

“…The influence exerted on lymphocytes or mesenchymal cells, i.e. fibroblasts or cu taneous appendages, may account for the efficacy of isotretinoin in sarcoidosis with cutaneous involvement [39], recalcitrant warts in immunosuppressive patients [40], and granuloma annulare of the disseminat ed type [41]. An efficacy of isotretinoin on cutaneous appendage-derived benign tumors like multiple syringomas has recent ly been reported [40].…”