title: Refractory chronic cutaneous sarcoidosis responsive to dose escalation of TNF-alpha antagonists.
abstract: Cutaneous sarcoidosis may be a chronic disease with important morbidity requiring aggressive therapy. The efficacy of different anti-tumor necrosis factor alpha(anti-TNF-alpha) 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-alpha 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.
authors.affiliation: Dermatology Department, Hôpitaux Universitaires de Genève, Geneva, Switzerland. anne-marie.thielen@hcuge.ch
authors.forename: A-M
authors.initials: AM
authors.lastname: Thielen
authors.forename: C
authors.initials: C
authors.lastname: Barde
authors.forename: J-H
authors.initials: JH
authors.lastname: Saurat
authors.forename: E
authors.initials: E
authors.lastname: Laffitte
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D002908:Chronic Disease; D005260:Female; D006801:Humans; D000069285:Infliximab; D012507:Sarcoidosis / Q000188:drug therapy*; D012871:Skin Diseases / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D000068879:Adalimumab