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Are steroids the only treatment for sarcoidosis?

Q: My husband is a patient of cutaneous sarcoidosis. For the last five months he is taking hydroxy chloquinine sulphate (HCQS). The response on the lesions is not visible although no new lesion was seen on the body. Now the doctor has decided to go in for intra lesion injection - Tricort 10. Is it worth trying or a steroid treatment is required?

A:Sarcoidosis is actually a systemic disorder which can affect any organ including skin. About a dozen medicines (other than steroids) including chloroquine and hydroxychloroquine have been tried but there is no evidence of their efficacy. Steroids remain the therapy of choice. While normally steroids (prednisolone - Wysolone: 1mg per kg of the body-wt daily for 4-6 weeks to be gradually withdrawn over the next 2-3 months) are normally given by mouth, an attempt can be made to use a steroid by local intralesional route provided there are only a few, well localized, focussed areas on the skin. It may or may not work.

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