Disseminated Cutaneous Sarcoidosis with Necrotizing Granulomas and Successful Dithranol Therapy in a 75-Year-Old Patient

Sarcoidosis is an inflammatory disease of unknown aetiology principally manifesting in the lungs and thoracic lymph nodes, but may affect a variety of other organ systems. Sarcoidosis of the skin may be associated with or without systemic disease and may present with a multifaceted clinical picture. The characteristic histological findings are non-caseating ("naked") granulomas without or with only few lymphocytes or plasma cells. Infrequently, a central necrosis may also be observed, similar to tuberculoid granulomas. Topical and/or systemic corticosteroids have been regarded as the gold standard for treatment of cutaneous sarcoidosis. Dithranol is primarily known as a topical antipsoriatic drug. To our knowledge, the usage of dithranol in cutaneous sarcoidosis has not yet been reported. It may be an effective treatment alternative to topical corticosteroids. We report the case of a patient treated with dithranol monotherapy with a favourable outcome.