How should cutaneous sarcoidosis be treated?

Treatment of cutaneous sarcoidosis should always be tempered by the fact that 60% to 80% of cases resolve without treatment in 1 to 2 years, especially those patients who present with Löfgren’s syndrome. For patients with mild cutaneous disease, potent topical corticosteroid (e.g., clobetasol) or intralesional corticosteroid is the treatment of choice. For patients with extensive cutaneous involvement or systemic disease, prednisone is the treatment of choice. Antimalarials have also been shown to be effective in the chronic plaque form of cutaneous sarcoidosis, and these can be a useful alternative to prednisone. Miscellaneous treatments reported to be of benefit in select patients include azathioprine, doxycycline, isotretinoin, levamisole, methotrexate, minocycline, thalidomide, tetracycline, adalimumab, and infliximab.

Doherty CB, Rosen T: Evidence-based therapy for cutaneous sarcoidosis, Drugs 68:1361–1383, 2008.