Biologic Therapy in the Treatment of Cutaneous Sarcoidosis: A Literature Review

Am J Clin Dermatol. 2019 Jun;20(3):409-422. doi: 10.1007/s40257-019-00428-8.


Sarcoidosis is an inflammatory disease defined by the presence of non-caseating granulomas. It can affect a number of organ systems, most commonly the lungs, lymph nodes, and skin. Cutaneous manifestations of sarcoidosis can impose a significant detriment to patients' quality of life. The accepted first-line therapy for cutaneous sarcoidosis consists of intralesional and oral corticosteroids, but these can fail in the face of resistant disease and corticosteroid-induced adverse effects. Second-line agents include tetracyclines, hydroxychloroquine, and methotrexate. Biologics are an emerging treatment option for the management of cutaneous sarcoidosis, but their role in management is not well-defined. In this article, we reviewed the currently available English-language publications on the use of biologics in managing cutaneous sarcoidosis. Although somewhat limited, the data in published studies support the use of both infliximab and adalimumab as third-line treatments for chronic or resistant cutaneous sarcoidosis. There were also scattered reports of etanercept, rituximab, golimumab, and ustekinumab being utilized as third-line agents with varying degrees of success. Larger and more extensive investigations are required to further assess the adverse effect profile and optimal dosing for managing cutaneous sarcoidosis.

Publication types

  • Review

MeSH terms

  • Adalimumab / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use
  • Biological Products / pharmacology
  • Biological Products / therapeutic use*
  • Drug Resistance
  • Etanercept / therapeutic use
  • Glucocorticoids / pharmacology*
  • Glucocorticoids / therapeutic use
  • Infliximab / therapeutic use
  • Off-Label Use
  • Sarcoidosis / drug therapy*
  • Sarcoidosis / immunology
  • Sarcoidosis / pathology
  • Skin Diseases / drug therapy*
  • Skin Diseases / immunology
  • Skin Diseases / pathology
  • Treatment Outcome


  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal
  • Biological Products
  • Glucocorticoids
  • golimumab
  • Infliximab
  • Adalimumab
  • Etanercept