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Refractory Chronic Cutaneous Sarcoidosis Responsive to Dose Escalation of TNF-Alpha Antagonists
A.-M. Thielen, C. Barde, J.-H. Saurat, E. Laffitte

Dermatology Department, Hôpitaux Universitaires de Genève, Geneva, Switzerland

Address of Corresponding Author

Dermatology 2009;219:59-62 (DOI: 10.1159/000221005)

  Key Words

• Sarcoidosis
• Tumor necrosis factor antagonists
• Infliximab
• Adalimumab
• Dose escalation

  Abstract

Cutaneous sarcoidosis may be a chronic disease with important morbidity requiring aggressive therapy. The efficacy of different anti-tumor necrosis factor (anti-TNF-) treatments in refractory cutaneous and systemic sarcoidosis has been reported previously. We report the first patient with chronic cutaneous sarcoidosis who responded to dose escalation of anti-TNF- agents that have been ineffective at the standard dosage, illustrating that the optimal dosing regimen has still to be defined for this indication before considering difficult-to-treat patients as nonresponders. Our case report also illustrates that the fusion protein etanercept, even used at a high dosage, may be less effective for the treatment of cutaneous sarcoidosis than the monoclonal antibodies infliximab and adalimumab.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Dr. Anne-Marie Thielen
Dermatology Department
24, rue Micheli-du-Crest
CH-1211 Genève 14 (Switzerland)
Tel. +41 22 372 94 23, Fax +41 22 372 94 70, E-Mail anne-marie.thielen@hcuge.ch

  Article Information

Dr. Anne-Marie Thielen, Caroline Barde, Jean-Hilaire Saurat and Emmanuel Laffitte acted as paid consultants for Wyeth (Enbrel®), Schering-Plough (Remicade®) and Abbott (Humira®).

Received: March 30, 2009
Accepted: April 17, 2009
Published online: May 25, 2009
Number of Print Pages : 4
Number of Figures : 4, Number of Tables : 0, Number of References : 17