Published in Cancer Detection and Prevention 2000; 24(Supplement 1).

Oral isotretinoin therapy for cutaneous sarcoidosis

S Georgiou MD, A Monastirli MD, E Pasmatzi MD, D Tsambaos MD

Dept Dermatology, University of Patras, Patras, Greece,

It is widely accepted that sarcoidosis may represent a macrophage-initiated and T-cell-mediated response to infectious antigens or autoantigens in genetically predisposed individuals. Diverse therapeutic approaches have been used in the management of cutaneous sarcoidosis but no form of therapy has yielded consistently effective results. AIMS : Considering the immunomodulatory potential of oral isotretinoin we found it of interest to investigate the therapeutic efficacy of this compound in cutaneous sarcoidosis. METHODS : A 31-year-old HIV-negative Caucasian female patient with a 3-year history of histologically confirmed cutaneous sarcoidosis presented to our Department. The response of her skin lesions to intralesional or oral steroids and to oral hydroxychloroquine was disappointing. Treatment was initiated with an oral isotretinoin dose of 1mg/kg/day. RESULTS : An 8-month continuous administration of this compound resulted in a complete remission of the cutaneous lesions. The patient remained free of recurrence for 31 months. However, the relapse showed an impressive response to retreatment with oral isotretinoin and the skin lesions completely resolved after 9 weeks of therapy. CONCLUSIONS: Our findings indicate that this compound may be regarded as an effective and safe alternative therapeutic approach in the management of cutaneous sarcoidosis.

KEY WORDS: Retinols, skin, granuloma.

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Paper presented at the International Symposium on Impact of Biotechnology on Cancer Diagnostic & Prognostic Indicators; Geneva, Switzerland; October 28 - 31, 2000; in the section on novel therapies.