Use a stepwise approach when selecting treatment for cutaneous sarcoidosis

Cutaneous Sarcoidosis: A Review and Approach to Treatment

“…Treatment for cutaneous sarcoidosis is based on the extent of the disease process, symptoms, and impact on life quality. 7 Treatment selection must consider the side effect profile and consider disease severity and rate of progression. Treatment protocols are summarized in Table 3.…”

“…Side effects include skin atrophy, hypopigmentation, telangiectasia, and striae. 3,6,7 Topical calcineurin inhibitors can be used as a corticosteroid-sparing agent. A twice-daily application of topical tacrolimus 0.1% would be a great option to use either to the face or localized skin lesions in conjunction with topical steroid use.…”

“…Side effects of topical calcineurin inhibitors include a burning sensation with the application of the topical. [6][7][8] Topical retinoids, such as tretinoin 0.1%, can also be considered in conjunction with topical steroids or nonsteroidal options. A pea-sized amount mixed with moisturizer is applied at bedtime to affected areas due to drying side effects.…”

“…A pea-sized amount mixed with moisturizer is applied at bedtime to affected areas due to drying side effects. 6,7 Non-topical treatment options include photo-dynamic therapy, laser therapy, and ultraviolet A (UVA) phototherapy. For localized cutaneous involvement, the stepwise consideration of laser and light therapy should be as follows: Pulsed dye laser (PDL) → Fractioned carbon dioxide (CO2) laser → Intense pulsed light therapy (IPL) → YAG or Q-switched ruby laser.…”

“…Treatment with lasers can lead to significant improvement in cutaneous lesions, however, patients can expect mild erythema and mild swelling post-procedure with the YAG laser and Q-switched ruby laser. [6][7][8] Mild to moderate disease. Oral tetracyclines such as doxycycline or minocycline can be considered in the treatment of mild to moderate disease.…”