Treatment principles
Medical management with oral corticosteroids is the mainstay of treatment in generalised sarcoidosis and in severe otolaryngologic disease (1, 9, 17). However, the risks of uncontrolled disease need to be balanced against the incumbent risks and side-effects of long-term corticosteroid therapy (10). Adjunctive or alternate drug therapies have therefore also been used in order to reduce steroid doses (18, 19). These include:
No control studies exist as yet comparing these therapies to steroid treatment, but effective treatment is reported anecdotally in cases of sarcoidosis with extrathoracic manifestations such as lupus pernio and uveitis (18, 19). Furthermore, specific treatments can be helpful in the local management of otorhinolaryngologic sarcoidosis, and these are discussed below.