Benefits

No systematic reviews or RCTs describing use of isotretinoin for treatment of cutaneous sarcoidosis were found. However, four cases of isotretinoin use in cutaneous sarcoidosis were identified. Georgiou et al.61 described a 31-year-old woman with a 3-year history of cutaneous sarcoid unresponsive to intralesional steroids, oral steroids and hydroxychloroquine. She experienced complete resolution of her skin lesions after 8 months' treatment with oral isotretinoin, 1 mg/kg/day. Waldinger et al.62 described a woman with severe disfiguring lesions of 4 years duration in whom treatment with oral prednisone and allopurinol had failed. She was treated with isotretinoin for 30 weeks (initially 40 mg/day for 6 weeks, increased to 80 mg/day for 16 weeks, decreased back to 40 mg/day for the last 8 weeks because of side-effects), and had resolution or improvement of many of her lesions. Spiteri et al.63 reported a case of a woman with chronic sarcoidosis treated with isotretinoin, 75 mg/day (decreased to 50 mg/day because of cheilitis) who had little resolution of her sarcoid nodules, and was withdrawn from the drug after 7 weeks because of the development of a severe exfoliative dermatitis. Vaillant et al.64 report on a woman with cutaneous sarcoid unresponsive to steroids, allopurinol, and antimalarials. She had improvement of her lesions after 6 months'

treatment with oral isotretinoin, 0-4-1-0 mg/kg/ day.

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