fumarates and Sarcoidosis--Pulmonary

Sarcoidosis is a rare, systemic disease that is characterized by the formation of granulomas in various organs, including the skin. As the etiology remains unknown, the treatment of sarcoidosis is challenging. We present a 47-year-old female patient with progressive, multi-organ sarcoidosis who had a complete clinical improvement of the skin lesions, a moderate reduction in pulmonary opacities on chest X-ray, a marked subjective improvement in general status and pulmonary efficiency and a marked reduction in serum angiotensin-converting enzyme and soluble interleukin-2 receptor after 6 months of therapy with fumaric acid esters. The present case and similar reports in the literature highlight the probable efficacy of fumaric acid esters in the treatment of sarcoidosis and other non-infectious, granulomatous diseases.

Topics: Administration, Oral; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Follow-Up Studies; Fumarates; Humans; Middle Aged; Radiography, Thoracic; Rare Diseases; Sarcoidosis; Sarcoidosis, Pulmonary; Severity of Illness Index; Skin Diseases; Treatment Outcome

A 43-year-old man with cutaneous and pulmonary sarcoidosis was treated with fumaric acid esters (Fumaderm®) for 11 months because of the cutaneous lesions. During the treatment the cutaneous lesions and pulmonary changes vanished completely. In addition, serum angiotensin converting enzyme (ACE) levels normalized after end of therapy. This case report is one of a few examples of the successful treatment of cutaneous and pulmonary sarcoidosis with fumaric acid esters (Fumaderm®).

Topics: Adult; Dermatitis; Dimethyl Fumarate; Fumarates; Humans; Male; Sarcoidosis; Sarcoidosis, Pulmonary; Treatment Outcome

A 61-year old female patient with cutaneous sarcoidosis was treated with fumaric acid esters (Fumaderm). After 12 months of therapy, lesions were markedly improved and treatment was discontinued. 18 months later, the cutaneous lesions recurred, angiotensin converting enzyme (ACE) serum levels were increased and a chest X-ray demonstrated pulmonary involvement. Therapy with fumaric acid esters was again started. The skin showed improvement after 2 months and completely cleared within 17 months, within 4 months ACE levels normalized, and within 10 months radiologic changes markedly resolved. This case demonstrates a possible role for fumaric acid esters not only in the treatment of cutaneous but also systemic sarcoidosis.

Topics: Dermatologic Agents; Dimethyl Fumarate; Female; Fumarates; Humans; Immunosuppressive Agents; Middle Aged; Recurrence; Sarcoidosis; Sarcoidosis, Pulmonary; Skin Diseases; Treatment Outcome