Background: Sarcoidosis is a noncaseating granulomatous disease that affects multiple systems, including the skin. Treatment for cutaneous sarcoidosis is varied and mostly based on anecdotal knowledge from the literature. The commonest treatment for cutaneous sarcoidosis involves topical, intralesional, and/or systemic corticosteroids. Other treatments, including retinoids, have been trialed with varying response.
Case presentation: A 71-year-old female had been diagnosed with cutaneous sarcoidosis when she was 59 years old. She was initially treated with corticosteroids, followed by methotrexate until the age of 68 years, at which point she was switched to acitretin due to failure of resolution on the previous treatment. The patient’s condition improved dramatically within 8 months of treatment.
Conclusion: A literature review identified eight other cases of cutaneous sarcoidosis treated with retinoids (isotretinoin in six cases and etretinate in two cases). Of these cases, only one responded unfavorably, whereas resolution was seen within 8 months in the other seven cases, similar to our case. This suggests that retinoids may be a potential treatment option for cutaneous sarcoidosis, possibly owing to their anti-inflammatory and immunomodulatory properties.
Key words: Retinoids, acitretin, granuloma, recalcitrant cutaneous sarcoidosis, case report.