The use of tetracyclines for the treatment of sarcoidosis

Background: To evaluate the safety and efficacy of minocycline in the treat ment of sarcoidosis, a nonrandomized, open study was performed in patients with cutaneous sarcoidosis. Observations: Twelve patients with cutaneous sarcoidosis were treated with minocycline, 200 mg/d, for a median duration of 12 months. Three patients h ad extracutaneous lesions at the time of the study. The median follow-up wa s 26 months. A clinical response was observed in 10 patients, consisting of complete responses in 8 patients and partial responses in 2 patients. A pr ogression of skin lesions was observed in 1 patient, and lesions remained s table in another patient. Adverse effects were minimal, except in 1 patient , who developed hypersensitivity syndrome. A slight hyperpigmentation occur red in 2 patients at the site of previous lesions, which completely disappe ared after minocycline use was discontinued. A relapse of skin symptoms occ urred after minocycline withdrawal in 3 patients, who further received doxy cycline, 200 mg/d, allowing a complete remission of lesions. Conclusions: These results support that minocycline and doxycycline may be beneficial for the treatment of cutaneous sarcoidosis. Randomized controlle d studies are warranted for the evaluation of the true efficacy of tetracyc lines in these patients.