Organ Involvement and Treatment Response across Cutaneous Sarcoidosis Subtypes

Area of Science:

• Dermatology
• Immunology
• Internal Medicine

Background:

• Cutaneous sarcoidosis exhibits varied presentations, but data comparing systemic involvement, disease progression, and treatment efficacy across subtypes are scarce.
• Limited comparative data exist for sarcoidosis subtypes regarding systemic disease, clinical course, and therapeutic outcomes.

Purpose of the Study:

• To analyze systemic involvement, disease course, and treatment response across different cutaneous sarcoidosis subtypes.
• To investigate variations in extracutaneous organ involvement and diagnostic pathways among sarcoidosis patients with and without skin manifestations.

Main Methods:

• A 2-center cross-sectional study of 125 patients with histologically confirmed sarcoidosis.
• Patients were stratified by cutaneous involvement and subtype; data on demographics, organ involvement, treatment, and clinical course were collected.
• Analysis included comparison of systemic involvement, treatment response rates, and relapse frequencies among subtypes.

Main Results:

• Papular sarcoidosis demonstrated the least systemic involvement; lymph nodes (64%) and lungs (48%) were most commonly affected.
• Topical therapy yielded low remission rates (11%), while systemic glucocorticoids (21%) and immunosuppressants (37%) were more effective.
• Sirolimus, hydroxychloroquine, and TNF inhibitors showed notable efficacy; 40% relapsed, and 46% required long-term systemic therapy.

Conclusions:

• Cutaneous sarcoidosis subtypes exhibit significant heterogeneity in systemic disease, treatment response, and clinical trajectory.
• These findings underscore the biological diversity of cutaneous sarcoidosis, necessitating tailored management strategies for each patient.
• Individualized treatment approaches are essential due to the distinct characteristics of various sarcoidosis subtypes.