Cutaneous sarcoidosis successfully treated with alefacept.
BACKGROUND
Sarcoidosis is a systemic granulomatous disease of unknown etiology that affects multiple organ systems, including the pulmonary, lymphatic, skeletal, and integumentary systems. Improved understanding of the intrinsic immunology and molecular biology in sarcoidosis can be applied to the treatment of this disease. Alefacept is a human fusion protein consisting of the extracellular domain of leukocyte function-associated antigen 3 fused with the Fc portion of human immunoglobulin G1. It works by blocking the interaction between antigen-presenting cells and T cells to inhibit activation and by inducing apoptosis of CD4+ T cells. In this case report, we describe a 46-year-old patient with recalcitrant lupus pernio who was successfully treated with alefacept.


OBJECTIVE
To determine whether T-cell inhibition, specifically the use of alefacept, may be used to treat a patient with recalcitrant cutaneous sarcoidosis.


METHODS
Case report.


RESULTS
There was a modest clinical improvement after 8 weeks of intramuscular injections of alefacept.


CONCLUSIONS
This case report provides further evidence of successful treatment of sarcoidosis with biologic agents directed against T-lymphocyte activation.
Garcia-Zuazaga
Jorge
J
Department of Dermatology, University Hospitals of Cleveland, Case Western Reserve University, OH 44106, USA. Jorge.Garcia-Zuazaga@uhhs.com
Korman
Neil J
NJ
D000077944:Alefacept; D001706:Biopsy; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects*; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005145:Face; D006801:Humans; D008297:Male; D008875:Middle Aged; D009666:Nose; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D012507:Sarcoidosis / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D012867:Skin / Q000473:pathology; D012871:Skin Diseases / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D016896:Treatment Outcome
D003879:Dermatologic Agents; D011993:Recombinant Fusion Proteins; D000077944:Alefacept