Management of Treatment-Resistant Cutaneous Sarcoidosis With Radiation

Frizzell, Bart; Stith, McLean; Jenrette, Joseph M.

doi:10.1097/00000421-200212000-00008

Cited by 17 publications

(3 citation statements)

References 21 publications

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“…After radiation therapy, a lower maintenance dose of steroid agents was successful in stabilizing disease. 5,9,12,20,29 With regard to neurosarcoidosis, radiation therapy has been used to treat both meningitic and solitary parenchymal lesions. Doses ranging from 10 to 30 Gy have reduced the size of the lesions or allowed the patient to be maintained on a lower dose of steroid drugs.…”

Section: Discussionmentioning

confidence: 99%

Sciatic nerve sarcoidosis: utility of magnetic resonance peripheral nerve imaging and treatment with radiation therapy

Dailey

Rondina

Townsend³

et al. 2004

Journal of Neurosurgery

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Sarcoidosis may involve both the central and peripheral nervous system, although peripheral nerve manifestations are usually seen late in the disease. In this report, the authors describe a case of sarcoidosis in a 22-year-old woman who presented with a foot drop. Although results of conventional lumbar magnetic resonance (MR) imaging were normal, MR peripheral nerve imaging of the thigh showed a mass in the sciatic nerve indicating tumor. An intraoperative biopsy sample revealed noncaseating granulomas consistent with sarcoid. The patient was treated with steroid drugs to control the manifestations of her disease but exhibited early signs of femoral bone necrosis, which required discontinuation of the steroids. She was then treated with local radiation therapy. At her 2-year follow-up visit the patient demonstrated relief of her symptoms and improvement on MR peripheral nerve imaging. This case demonstrates that sarcoidosis may present with peripheral nerve manifestations. The appearance of a diffusely swollen nerve on MR imaging should prompt clinicians to include sarcoidosis in the differential diagnosis and plan surgery accordingly. Patients who are not responsive to or who are unable to tolerate medical therapy may be treated with radiation therapy.

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Section: Discussionmentioning

confidence: 99%

Sciatic nerve sarcoidosis: utility of magnetic resonance peripheral nerve imaging and treatment with radiation therapy

Dailey

Rondina

Townsend³

et al. 2004

Journal of Neurosurgery

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“…Radiation therapy for sarcoidosis has been used with various degrees of success [127][128][129][130][131][132][133][134][135][136][137][138][139][140][141][142]. However, toxicities associated with radiation therapy for sarcoidosis can be severe, including lung fibrosis [141], headaches, weakness, seizures [130], radiation-induced malignancy and dementia.…”

Section: Radiation Therapymentioning

confidence: 99%

Current and emerging strategies for the management of sarcoidosis

White¹,

Lynch²

2007

Expert Opinion on Pharmacotherapy

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Sarcoidosis is a systemic inflammatory disorder of unknown etiology. Although any organ may be involved, the lungs are most frequently affected. The clinical course of the disease is highly variable, with up to two-thirds of untreated patients experiencing spontaneous remission within 12-24 months of onset of symptoms. When therapy is required, corticosteroids are considered standard, but studies demonstrating their ability to modify the long-term outcome in this disease are lacking. Often, the myriad of adverse side effects of corticosteroids necessitate the addition of immunosuppressants, cytotoxic agents or biologic therapies to maintain disease remission. Unfortunately, optimal therapeutic regimens have not been described. Patients who do not respond to therapy often experience progressive fibrotic changes and end-organ damage, which ultimately may result in significant morbidity or death. Agents commonly used to treat patients with sarcoidosis and emerging therapeutic options are discussed.

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“…Phototherapie [11,19], Tacrolimus [16] oder Radiatio [9] beschrieben. Kürzlich wurde in 2 Publikationen über den positiven Effekt einer Fumarsäureesterthera-pie auf kutane Läsionen einer Sarkoidose bei 5 Patienten berichtet [7,21].Wir stellen hier eine weitere Patientin vor,bei der sich sowohl kutane als auch pulmonale Läsio-nen einer Sarkoidose unter Fumarsäu-reesterbehandlung deutlich zurückgebil-det hatten.…”

Section: Erfolgreiche Therapie Einer Haut-und Lungensarkoidose Mit Fuunclassified

Erfolgreiche Therapie einer Haut- und Lungensarkoidose mit Fumars�ureestern

2004

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A 61-year old female patient with cutaneous sarcoidosis was treated with fumaric acid esters (Fumaderm). After 12 months of therapy, lesions were markedly improved and treatment was discontinued. 18 months later, the cutaneous lesions recurred, angiotensin converting enzyme (ACE) serum levels were increased and a chest X-ray demonstrated pulmonary involvement. Therapy with fumaric acid esters was again started. The skin showed improvement after 2 months and completely cleared within 17 months, within 4 months ACE levels normalized, and within 10 months radiologic changes markedly resolved. This case demonstrates a possible role for fumaric acid esters not only in the treatment of cutaneous but also systemic sarcoidosis.

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Management of Treatment-Resistant Cutaneous Sarcoidosis With Radiation

Cited by 17 publications

References 21 publications

Sciatic nerve sarcoidosis: utility of magnetic resonance peripheral nerve imaging and treatment with radiation therapy

Sciatic nerve sarcoidosis: utility of magnetic resonance peripheral nerve imaging and treatment with radiation therapy

Current and emerging strategies for the management of sarcoidosis

Erfolgreiche Therapie einer Haut- und Lungensarkoidose mit Fumars�ureestern

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