After reviewing the available data on the oral therapy of cutaneous sarcoidosis, there is sparse evidence-based medicine. There is a desperate need for RCTs in this cutaneous disorder. Although oral steroids have been "grandfathered in" as the first-line treatment on the basis of many clinicians' personal experience on sarcoidosis, it has not been proven in clinical trials for cutaneous sarcoidosis.
The available reported evidence-based data suggest that chloroquine or hydroxychloroquine are the most effective agents available for the treatment of cutaneous sarcoidosis. Additional agents, in order of available evidence and side-effects, would include: methotrexate, allopurinol, minocycline, isotretinoin and thalidomide.
Several other drugs have been reported in isolated case reports (1-3 patients) as successful; these include tranilast,65 melatonin,66 clofazimine,67 mepacrine68 and infliximab.69 Levamisole was studied in 16 patients with cutaneous sarcoid and was found to be effective in only two of the 13 patients completing the course of treatment. It was concluded not to be useful in the treatment of cutaneous sarcoidosis.70
What are the effects of non-oral therapeutic interventions in patients with cutaneous sarcoidosis?
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