Scar sarcoidosis--treatment with the Q-switched ruby laser

Scar sarcoidosis is a circumscribed form of cutaneous sarcoidosis, which is often very difficult to treat. To date, therapeutic approaches have yielded little success and often been accompanied by adverse effects, some of which are severe. Laser treatment is one alternative, which has proven to be effective in a dramatically increasing number of cases over the past years.

We report about a 50-year-old female patient who presented with histologically confirmed scar sarcoidosis on the right elbow and both knees; the sarcoidosis had spontaneously developed on three sites which had traumatic tattoos from abrasions. Because of the reddish-brown livid discolorations, we treated the granulomas with the pulsed dye laser for three sessions, although without success. Treatment with the Q-switched ruby laser was commenced to remove the traumatic tattoos.

Not only had the areas lightened fully after four sessions, the sarcoidosis foci had resolved completely, and the patient has been recurrence-free for over 3 years.

The Q-switched ruby laser appears to be a rapid and effective means of treating scar sarcoidosis with traumatic tattoos without incurring adverse effects. The definitive mode of action is still not fully known, however.