Three cases of cutaneous sarcoidosis: search for bacterial agent by the 16S RNA gene analysis and treatment with antibiotics.
BACKGROUND
The aetiology of sarcoidosis remains controversial. An infectious origin is often discussed, but only anti-inflammatory or immunosuppressive treatment is recommended.


OBJECTIVE
To investigate the hypothesis of bacterial origin by treating cutaneous sarcoidosis with antibiotics.


METHODS
Patients with chronic cutaneous sarcoidosis, unresponsive to the usual treatment and not requiring systemic corticotherapy, were given combined antibiotherapy for 6 months. Search for bacterial DNA by amplification and sequencing of the 16S ribosomal RNA gene in skin biopsies of lesions before and after antibiotherapy was done.


RESULTS
Three patients received a combined treatment with clarithromycin 1 g/day and ciprofloxacin 1 g/day. No clinical changes occurred in 2 cases and transient worsening in 1. Amplification for bacterial DNA was positive in all skin biopsies. The sequencing of this DNA could not identify a unique bacterial species.


CONCLUSIONS
No evident bacterial origin could be demonstrated; however, this approach should be extended to more patients.
Toutous-Trellu
L
L
Service de dermatologie, DHURDV, Hôpital Universitaire de Genève, Suisse. laurence.trellu@hcuge.ch
Ninet
B
B
Rohner
P
P
Auckenthaler
R
R
Saurat
J H
JH
Pechère
M
M
D000328:Adult; D002939:Ciprofloxacin / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D004269:DNA, Bacterial / Q000235:genetics; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012507:Sarcoidosis / Q000188:drug therapy* / Q000382:microbiology; D012867:Skin / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D012871:Skin Diseases / Q000188:drug therapy* / Q000382:microbiology; D016896:Treatment Outcome
D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S; D002939:Ciprofloxacin; D017291:Clarithromycin