[Treatment of sarcoidosis]

Abstract

The treatment of sarcoidosis remains empirical. In severe cases, it is based on systemic corticosteroid therapy which is highly effective on granulomatous lesions and immune and metabolic disorders. Its limitations are its purely "suspensive" effect, its lack of efficacity on fibrous lesions and its side effects. It is widely accepted in the case of poorly tolerated, recent sarcoidosis and respiratory or extrarespiratory involvement, modification of the general status, or hypercalcaemia. In these cases, its therapeutic effect is spectacular. Corticosteroid treatment is also indicated in most chronic forms having development of fibrosis. Complementary examinations, especially CT scan of the chest, can be useful in treatment decision. Failure or contraindication of corticosteroids suggests the use of synthetic antimalarial drugs or methotrexate. Local corticosteroids are useful in treatment of ophthalmologic or skin localisations.