When specific (granulomatous) cutaneous sarcoidosis lesions are cosmetically significant, numerous, or generalized in distribution, local therapy alone is typically insufficient. Systemic pharmacotherapy becomes necessary to adequately manage skin disease at this extent.
This protocol applies to patients with specific granulomatous cutaneous sarcoidosis lesions that are cosmetically important or involve several to generalized areas of skin. When lesions do not respond to local therapy, or when skin disease is more generalized, some type of pharmacotherapy is required.
Systemic therapy typically begins with corticosteroids for short-term disease control. Because of their potential long-term side effects, steroid-sparing agents — drawn from antimalarial, immunosuppressive, and antibiotic drug classes — are considered for sustained management. The appropriate choice and sequencing among these options depends on individual patient factors covered in the full protocol.