There are no systematic reviews or RCTs of the role of plastic surgery in the treatment of cutaneous sarcoidosis; however, several case reports were found. In 1970, O'Brien described two patients successfully treated with plastic surgery for lupus pernio.75 In 1984, Shaw etal.76 described a man with a 6-year history of treatment-resistant lupus pernio successfully treated with surgical excision and split skin grafting; the result remained good 2-5 years after surgery. Collison et al77 described a man with extensive ulcerative nodules of the lower extremities, which were resistant to topical/intralesional steroids, oral steroids, hydroxychloroquine and methotrexate. He was treated with vigorous operative debridement and partial-thickness skin grafting. While the grafts were well accepted (80%), the patient developed new ulcerating nodules in previously uninvolved skin 2 months after surgery. Stack etal.78 report on a black male with extensive facial lesions who was treated with CO2 laser excision, followed by steroid injection. The wounds healed well, and the patient had no recurrence of lesions 2 years after surgery. Streit et al79 report the case of a woman with widespread ulcerative cutaneous sarcoidosis treated with Apligraf (graftskin), a bilayered human skin equivalent, with good results.
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