This protocol covers cutaneous sarcoidosis presenting specifically as lupus pernio — potentially disfiguring lesions that occur on the face, particularly on or around the nose, around the eyes, or around the mouth.
The evidence-based regimen for lupus pernio involves anti-TNF therapy. Given the toxicity profile of this class, the risk-benefit ratio must be carefully assessed for this chronic cutaneous condition. Specific agents, combinations, and sequencing are detailed in the full protocol.
Other specific skin lesions include skin nodules that develop on old scars and tattoos; lesions that look like ulcers; lesions that may be mistaken for psoriasis; and lupus pernio, potentially disfiguring lesions that occur on the face, particularly on or around the nose, around the eyes or mouth.
For lupus pernio, a large retrospective study reported that anti-TNF therapy was significantly better than cytotoxic or antimalarial therapy, and it could be considered as second-line therapy for this particular form of skin sarcoidosis.
However, anti-TNF therapy is associated with more toxicity and the risk/benefit ratio must be considered in treating this chronic cutaneous condition.
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