Biologic Therapy in the Treatment of Cutaneous Sarcoidosis: A Literature Review

Dai, Christina; Shih, Shawn; Ansari, Ahmed; Kwak, Young Lan; Sami, Naveed

doi:10.1007/s40257-019-00428-8

Cited by 32 publications

(21 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is also data suggesting a possible benefit with newer immunomodulatory agents such as the TNF‐α blockers infliximab and adalimumab. Other biologics reported to have been used (with varying success) include etanercept (binds to TFN‐α and TNF‐β) and golimumab (anti‐TNF‐α antibody) as well as rituximab (CD20 antibody) and ustekinumab (IL‐12/IL23 antibody) .…”

Section: Granulomatous Dermatoses In Systemic Diseasementioning

confidence: 99%

Non‐infectious granulomatous dermatoses

Schmitt¹,

Völz

2019

J Deutsche Derma Gesell

View full text Add to dashboard Cite

Summary Granulomatous dermatoses comprise a wide range of etiologically and clinically distinct skin diseases that share a common histology characterized by the accumulation of histiocytes include macrophages. While the pathogenesis of these disorders is not fully understood, the underlying mechanism is thought to involve a reaction pattern caused by an immunogenic stimulus. Antigen‐presenting cells and the effect of various cytokines play a key role. Our understanding of granulomatous reaction patterns has been advanced by insights drawn from observations of such reactions in patients on immunomodulatory therapy and in individuals with genetic immunodeficiency. Traditionally, a distinction is made between infectious and non‐infectious granulomatous dermatoses. The present CME article addresses granulomatous skin diseases for which there is no evidence of a causative infectious agent. Common representatives include granuloma annulare, necrobiosis lipoidica and cutaneous sarcoidosis. Granulomatous dermatoses may be part of the clinical spectrum of various systemic disorders or may be associated therewith. Some neoplastic disorders may mimic granulomatous dermatoses histologically. Given the pathogenetic diversity involved, the clinical presentation, too, is quite varied. Overall, however, each disorder is characterized by typical clinical features. The diagnosis always requires thorough clinicopathologic correlation. Treatment is preferably based on the underlying pathogenesis and frequently involves anti‐inflammatory agents. In most cases, however, there is insufficient study data. The dermal nature of these disorders frequently poses a therapeutic challenge, especially with respect to topical treatment.

show abstract

Section: Granulomatous Dermatoses In Systemic Diseasementioning

confidence: 99%

Non‐infectious granulomatous dermatoses

Schmitt¹,

Völz

2019

J Deutsche Derma Gesell

View full text Add to dashboard Cite

show abstract

“…Die Datenlage weist auch auf einen möglichen Erfolg neuerer immunmodulatorischer Substanzen wie die TNF‐α–Blocker Infliximab und Adalimumab hin. Einzelne Berichte mit unterschiedlichem Erfolg existieren daher ebenfalls für Etanercept (bindet TFN‐α und TNF‐β) und Golimumab (Anti‐TNF‐α‐Antikörper) wie auch für Rituximab (CD20‐Antikörper) und Ustekinumab (IL‐12‐, IL23‐Antikörper) .…”

Section: Granulomatöse Dermatosen Bei Systemerkrankungenunclassified

Nicht‐infektiöse granulomatöse Dermatosen

Schmitt¹,

Völz

2019

J Deutsche Derma Gesell

View full text Add to dashboard Cite

Zusammenfassung Granulomatöse Dermatosen umfassen ein breites Spektrum ätiologisch und klinisch heterogener Dermatosen, deren Gemeinsamkeit in einem histologisch von Histiozyten‐ bzw. Makrophagen‐Akkumulation geprägten Bild liegt. Die Pathogenese der einzelnen Krankheitsbilder ist unvollständig verstanden. Als Mechanismus wird zumeist ein Reaktionsmuster des Organismus auf einen immunogenen Stimulus angenommen. Antigenpräsentierende Zellen und der Einfluss unterschiedlicher Zytokine spielen eine Schlüsselrolle. Erkenntnisse zu granulomatösen Reaktionen unter iatrogener Immunmodifikation sowie bei genetisch determinierten Schwächen der Immunabwehr verbessern unser Verständnis granulomatöser Reaktionsmuster. Üblicherweise werden infektiöse granulomatöse von nicht‐infektiösen granulomatösen Dermatosen unterschieden. Der vorliegende Artikel behandelt granulomatösen Dermatosen ohne nachweislich kausalen Erregerbezug. Zu den klassischen Vertretern nicht erregerbedingter granulomatöser Dermatosen zählen das Granuloma anulare, die Necrobiosis lipoidica und die kutane Sarkoidose. Granulomatöse Dermatosen können kutane Manifestation einer systemischen Erkrankung darstellen oder mit einer solchen assoziiert sein. neoplastischen Erkrankungen, können das Bild einer granulomatösen Dermatose imitieren. Das klinische Bild ist entsprechend der pathogenetischen Vielfalt heterogen, insgesamt jedoch meist charakteristisch für das jeweilige Krankheitsbild. Die Diagnosestellung erfordert regelhaft eine gute klinisch‐pathologische Korrelation. Die Behandlung orientiert sich an der Pathogenese und erfolgt oft antientzündlich. Allerdings besteht meist eine unzureichende Datenlage und der dermale Charakter der Erkrankung erschwert die topische Behandlung.

show abstract

“…For localized disease, fi rst-line therapy consists in: intralesional or topical corticosteroids. In case of systemic disease, the options are: oral glucocorticoids, antimalaric drugs (hydroxychloroquine or chloroquine), methotrexate, tetracyclines 9,10 .…”

Section: Case Reportmentioning

confidence: 99%

Cutaneous Sarcoidosis – Diagnostic Challenges

Şandru¹,

Pharmacy²,

Dumitrașcu³

et al. 2019

Rev. Med. Mod.

View full text Add to dashboard Cite

Sarcoidosis is a multisystemic granulomatous disease, with unknown etiology, characterized histopathologically by the development in the affected organs of some "empty" (non-caseous) granulomas. Cutaneous lesions can sometimes be the fi rst localization of the disease. We present the case of a patient with known sarcoidosis and autoimmune thyroiditis, who developed a rash spread on the trunk and limbs, for which she was treated with dermatocorticoids and antihistamines, but without signifi cant improvement. A skin biopsy was performed with histopathological examination, which revealed: at the dermal level, lympho-histiocytic infi ltrates with nodular distribution, forming several granulomas, without areas of necrosis of caseifi cation, including frequent cells with epithelioid appearance, suggestive for the diagnosis of cutaneous sarcoidosis. The patient underwent systemic cortisone therapy and hydroxychloroquine, with favorable outcome. The challenge of diagnosing this pathology is to differentiate it from a number of conditions, including: ring granuloma, cutaneous Crohn's disease, lipoid necrosis, lupus vulgaris. To establish the diagnosis of certainty, it is necessary to correlate the clinical data with the result of the histopathological examination.

show abstract

Biologic Therapy in the Treatment of Cutaneous Sarcoidosis: A Literature Review

Cited by 32 publications

References 52 publications

Non‐infectious granulomatous dermatoses

Non‐infectious granulomatous dermatoses

Nicht‐infektiöse granulomatöse Dermatosen

Cutaneous Sarcoidosis – Diagnostic Challenges

Contact Info

Product

Resources

About