Topical tacrolimus for the treatment of cutaneous sarcoidosis

Green, C. M.

doi:10.1111/j.1365-2230.2007.02397.x

Cited by 25 publications

(7 citation statements)

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“…Similarly, topical tacrolimus (used alone or alternating with topical corticosteroids) applied once to twice daily also has been reported to be beneficial and is advantageous, because it does not lead to skin atrophy as can occur with topical steroids. 130,131 Topical retinoids also can be used as an adjuvant therapy to help with dyspigmentation or scaling. Fig.…”

Section: Differential Diagnosismentioning

confidence: 99%

Cutaneous Sarcoidosis

Wanat

Rosenbach

2015

Clinics in Chest Medicine

109

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The skin is the second most common organ affected in sarcoidosis, which can affect patients of all ages and races, with African American women having the highest rates of sarcoidosis in the United States. The cutaneous manifestations are protean and can reflect involvement of sarcoidal granulomas within the lesion or represent reactive non-specific inflammation, as seen with erythema nodosum. Systemic work-up is necessary in any patient with cutaneous involvement of sarcoidal granulomas, and treatment depends on other organ involvement and severity of clinical disease. Skin-directed therapies are first line for mild disease, and immunomodulators or immunosuppressants may be necessary.

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Section: Differential Diagnosismentioning

confidence: 99%

Cutaneous Sarcoidosis

Wanat

Rosenbach

2015

Clinics in Chest Medicine

109

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“…Topikal takrolimusun olgumuzda var olan skar sarkoidozunda hızlı, güvenli ve etkili bir tedavi seçeneği olduğu görülmüştür. Topikal takrolimus tedavisinin topikal steroid tedavisine yanıt vermeyen yüzde yerleşmiş [6][7][8][9] , dizde yerleşmiş likenoid tipte 10 ve sistemik steroid tedavisine yanıt vermeyen kaşa uygulanmış dövme skarında yerleşmiş 11 kutanöz sarkoidoz lezyonlarında etkinliği gösterilmiştir. Topikal takrolimus tedavisinin kutanöz sarkoidozda etkisini yardımcı Th1 hücrelerinin aktivasyonu, sitokin salınımı ile T hücreler ve makrofajlar tarafından TNF-α salınımını engelleyerek gösterdiği düşünülmüştür 6 .…”

Section: Discussionunclassified

“…5 Bunlardan kalsinörin inhibitörü olan takrolimusun topikal kullanımının özgül kutanöz sarkoidoz lezyonlarının tedavisinde etkili olabileceği daha önce bildirilen az sayıda olgu ile gösterilmiştir. [6][7][8][9][10][11] Bu yazıda topikal takrolimus tedavisine iyi yanıt veren, ender görülen bir kutanöz sarkoidoz formu olan skar sarkoidozlu bir olgu sunulması amaçlanmıştır.…”

Section: Gi Riflunclassified

Topikal Takrolimus Tedavisine Çok İyi Yanıt Veren Skar Sarkoidozu

Aksoy¹,

Aksoy²,

Akın³

et al. 2011

Turkderm

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ÖzetBüyük taklitçilerden birisi olan kutanöz sarkoidoz hala patogenezi tam olarak anlaşılamamış ve klinikte çok farklı şekillerde karşımı-za çıkabilen bulmaca gibi bir klinik antitedir. Elli sekiz yaşında kadın hasta 35 yıl önce oluşan skarlarda 5 aydır ortaya çıkan kabarma yakınması ile polikliniğimize başvurdu. Dermatolojik muayenede farklı bölgelerdeki skarlarda kabarıklık şeklinde lineer bakır kırmızı-morumsu plaklar ve diaskopide elma jölesi bulgusu tespit edildi. Alınan punch biyopsinin histopatolojik incelemesinde non-kazeifiye multifokal granulomatöz yapılar tespit edildi. Olguya yapılan incelemeler sonucunda evre I akciğer tutulumlu kutanöz skar sarkoidozu tanısı konuldu. Başlanan topikal takrolimus tedavisi ile altıncı haftadaki kontrolde lezyonlarda belirgin gerileme gözlendi ve 5 ay sonra nüks saptanmadı. Eski skarlarda infiltrasyon ile başvuran hastalarda skar sarkoidozu akla gelmesi gereken bir tanıdır ve mutlaka histopatolojik inceleme ile doğrulanmalıdır. Benzer hastalar sistemik tutulum açısından ayrıntılı inceleme yapıldıktan sonra kutanöz sarkoidoz için literatürde genelde bildirilen sistemik kortikosteroid yerine topikal takrolimus ile güvenli ve etkili bir şekilde tedavi edilebilir. (Türk derm 2011; 45: 219-21) Anah tar Ke li me ler: Sarkoidoz, skar, takrolimus, tedavi, topikal Sum maryAs a great imitator, sarcoidosis is a puzzling clinical entity that can present with diverse clinical pictures and its pathogenesis is still unknown. A 58-year-old woman applied to our outpatient clinic with a complaint of swelling of scars in her body present for 5 months and her scars were present for 35 years. On dermatological examination, enlargement of scars was observed in different areas of the patient's body and these were seen as linear copper red-violaceous plaques with apple-jelly sign on diascopy. Histopathological examination of a punch biopsy specimen revealed non-caseating granulomatous structures. Following detailed examinations, the case was diagnosed as having scar sarcoidosis with stage I lung involvement. Significant regression of lesions was detected at 6th week follow-up examination after commencement of topical tacrolimus treatment and there was not any relapse of the lesions after 5 months of treatment. The diagnosis of scar sarcoidosis should be remembered in cases who apply with the finding of infiltration of old scars and this diagnosis must be confirmed by using histopathological examination. Instead of using systemic corticosteroids, which is reported frequently for the treatment of cutaneous sarcoidosis in the literature, such cases can be treated safely and effectively with topical tacrolimus following a detailed examination for detection of systemic involvement. (Turk derm 2011; 45: 219-21

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“…Because of the risk for skin atrophy with potent corticosteroids, caution must be exercised when using these agents on the face. Topical tacrolimus [152,153] and localized photodynamic therapy [154] have also been reported to be beneficial in localized skin lesions of sarcoidosis. For extrapulmonary organ involvement that is not amenable to topical/local therapy (cardiac, neurologic, hepatic, etc.…”

Section: Extrapulmonary Sarcoidosismentioning

confidence: 98%

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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Topical tacrolimus for the treatment of cutaneous sarcoidosis

Cited by 25 publications

References 1 publication

Cutaneous Sarcoidosis

Cutaneous Sarcoidosis

Topikal Takrolimus Tedavisine Çok İyi Yanıt Veren Skar Sarkoidozu

Current and emerging strategies for the management of sarcoidosis

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