Commentimplications for clinical practice

Randomised controlled data exist to support the use of oral steroids for the pulmonary manifestations of sarcoidosis; however, very little objective data exist to support the use of steroids for the cutaneous manifestations of sarcoidosis. In the articles reviewed 56 patients were treated with oral steroids alone, of whom 17 had positive results. In patients with sarcoidosis for whom the main indication for treatment is cutaneous lesions, there is insufficient evidence to conclude that oral steroids are beneficial. Large randomised placebo-controlled therapeutic trials will be necessary for definitive proof.

Despite the lack of randomised-controlled data on oral steroids for cutaneous sarcoidosis, many dermatologists use it as first-line therapy. This is based on steroids reversing the manifestations of pulmonary and other extrapulmonary changes of sarcoidosis.4,28-30

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