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75 mg/day (decreased to 50 mg/day because of cheilitis) who had little resolution of her sarcoid nodules, and was withdrawn from the drug after 7 weeks because of the development of a severe exfoliative dermatitis.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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