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Treatment of Cutaneous Sarcoidosis With Chloroquine: Review of the Literature

Treatment of Cutaneous Sarcoidosis With Chloroquine: Review of the Literature Abstract • Systemic corticosteroids may be either contraindicated or not efficacious in treating the cutaneous manifestations occurring in 20% to 35% of patients with systemic sarcoidosis. Chloroquine phosphate has been reported to be a valuable alternative therapy for cutaneous lesions of sarcoidosis. With a judiciously determined daily dosage and regular 6-month ophthalmologic follow-up examinations, the risk of developing retinopathy can be avoided, because the daily dosage rate rather than total dose accumulation determines the development of chloroquine-induced retinopathy. We reviewed the efficacy and safety of chloroquine and its role in the treatment of cutaneous sarcoidosis. (Arch Dermatol. 1991;127:1034-1040) References 1. Kerdel FA, Moschella SL. Sarcoidosis: an updated review . J Am Acad Dermatol. 1984;11:1-19.Crossref 2. Poe RH, Utell MJ. Diagnosis and management of pulmonary sarcoidosis . Compr Ther. 1989;15:35-42. 3. James DG. Dermatological aspects of sarcoidosis . Q J Med. 1959;28:108-124. 4. Cronin E. Skin changes in sarcoidosis . Postgrad Med J. 1970;46:507-509.Crossref 5. Sharma OP. Cutaneous sarcoidosis: clinical features and management . Chest. 1972;61:320-325.Crossref 6. Elgart ML. Cutaneous lesions of sarcoidosis . Prim Care. 1978;5:249-262. 7. Olive KE, Kataria YP. Cutaneous manifestations of sarcoidosis: relationships to other organ system involvement, abnormal laboratory measurements, and disease course . Arch Intern Med. 1985;145:1811-1814.Crossref 8. Veien NK. Cutaneous sarcoidosis: prognosis and treatment . Clin Dermatol. 1986;4:75-87.Crossref 9. O'Leary TJ, Jones G, Yip A, Lohnes D, Cohanium M, Yendt ER. The effects of chloroquine on serum 1,25-dihydroxyvitamin D and calcium metabolism in sarcoidosis . N Engl J Med. 1986;315:727-730.Crossref 10. Shaffer B, Cahn MM, Levy EJ. Sarcoidosis apparently cured by quinacrine (Atabrine) hydrochloride . Arch Dermatol. 1953; 67:640-641. 11. Klauder JV. Sarcoid of the eyelids, conjunctiva, and uveal tract treated with quinacrine hydrochloride (Atabrine dihydrochloride) . Arch Dermatol. 1953;68:474. 12. Soderstrom N. Two cases of sarcoidosis treated with mepacrine . Lancet. 1960;2:947-948.Crossref 13. Fuld H. Sarcoidosis treated with chloroquine . Lancet. 1960;2:1029-1030.Crossref 14. Morse SI, Cohn ZA, Hirsch JG, Shaedler RW. The treatment of sarcoidosis with chloroquine . Am J Med. 1961;30:779-784.Crossref 15. Hirsch JG. Experimental treatment with chloroquine . Am Rev Respir Dis. 1961;84:52-58. 16. Hunt BJ, Yendt ER. The response of hypercalcemia in sarcoidosis to chloroquine . Ann Intern Med. 1963;59:554-563.Crossref 17. Barré PE, Gascon-Barré M, Meakins JL, Goltzman D. Hydroxychloroquine treatment of hypercalcemia in a patient with sarcoidosis undergoing hemodialysis . Am J Med. 1987;82:1259-1262.Crossref 18. Adams JS, Diz MM, Sharma OP. Effective reduction in the serum 1,25-dihydroxyvitamin D and calcium concentration in sarcoidosis associated hypercalcemia with short-course chloroquine therapy . Ann Intern Med. 1989;111:437-438.Crossref 19. Davies D. Sarcoidosis treated by chloroquine . Br J Dis Chest. 1963;57:30-36.Crossref 20. Siltzbach LE, Teirstein AS. Chloroquine therapy in 43 patients with intrathoracic and cutaneous sarcoidosis . Acta Med Scand. 1964;176( (suppl 425) ):302-308.Crossref 21. Morse SI. The therapeutic effect of chloroquine in sarcoidosis . In: Turiaf J, Chabot J, eds. La Sarcoidose: Rapports de la IV Conference International . Paris, France: Mason & Co; 1967:755-771. 22. British Tuberculosis Association. Chloroquine in the treatment of sarcoidosis: a report of the research committee of the British Tuberculosis Association . Tubercle. 1967;48:257-272.Crossref 23. Krasnitz A. Chloroquine therapy in pulmonary sarcoidosis . N Y State J Med. 1967;67:1729-1736. 24. Brodthagen H, Gilg I. Hydroxychloroquine in the treatment of sarcoidosis , In: Turiaf J, Chabot J, eds. La Sarcoidose: Rapports de la IV Conference International . Paris, France: Mason & Co; 1967:764-767. 25. Brodthagen H. Chloroquine in pulmonary sarcoidosis . Lancet. 1968;1:1157.Crossref 26. Schwartz RA, Robertson DB, Tierney LM, McNutt NS. Generalized ulcerative sarcoidosis . Arch Dermatol. 1982;118:931-933.Crossref 27. Johns CJ, Schonfeld SA, Scott PP, Zachary JB, MacGregor MI. Longitudinal study of chronic sarcoidosis with low-dose maintenance corticosteroid therapy: outcome and complications . Ann N Y Acad Sci. 1986;465:702-712.Crossref 28. Verdegem TD, Sharma OP. Cutaneous ulcers in sarcoidosis . Arch Dermatol. 1987;123:1531-1534.Crossref 29. Jones E, Callen JP. Hydroxychloroquine is effective therapy for control of cutaneous sarcoidal granulomas . J Am Acad Dermatol. 1990;23:487-489.Crossref 30. Fanburg BL. Drug therapy reviews: treatment of sarcoidosis . Am J Hosp Pharm. 1979;36:351-354. 31. Dukes MNG, ed. Meyer's Side Effects of Drugs . 11th ed. Amsterdam, the Netherlands: Elsevier Science Publishers; 1988. 32. Gilman AG, Rall TW, Nies AS, Taylor P, eds. Goodman's and Gilman's: The Pharmacological Basis of Therapeutics. 8th ed. Elmsford, NY: Pergamon Press Inc; 1990. 33. Knoben JE, Anderson PO, eds. Handbook of Clinical Drug Data . 6th ed. Hamilton, Ill: Drug Intelligence Publications Inc; 1988. 34. American Medical Association. Drug Evaluations . 6th ed. Chicago, Ill: American Medical Association; 1986:1071. 35. Easterbrook M. Ocular effects and safety of antimalarial agents . Am J Med. 1988;85:23-29.Crossref 36. Fraunfelder FT. Drug-Induced Ocular Side Effects and Drug Interactions . 3rd ed. Philadelphia, Pa: Lea & Febiger; 1986:60. 37. Hobbs HE, Sorsby A, Freedman A. Retinopathy following chloroquine therapy . Lancet. 1958;2:478-480. 38. Burns RP. Delayed onset of chloroquine retinopathy . N Engl J Med. 1966;275:693-696.Crossref 39. Percival SPB, Meancock I. Chloroquine: ophthalmologic safety and clinical assessment in rheumatoid arthritis . BMJ. 1968;3:579-584.Crossref 40. Marks JS. Chloroquine retinopathy: is there a safe daily dose? Ann Rheum Dis. 1982;41:52-58.Crossref 41. Easterbrook M. Dose relationships in patients with early chloroquine retinopathy . J Rheumatol. 1987;14:472-475. 42. Olansky AJ. Antimalarials and ophthamologic safety . J Am Acad Dermatol. 1982;6:19-23.Crossref 43. Mackenzie AH. Dose refinements in long-term therapy of rheumatoid arthritis with antimalarials . Am J Med. 1983;75( (1A) ):40-45.Crossref 44. Ochsendorf FR, Runne U. Chloroquine retinopathy: preventable by monitoring the maximum daily dose . Hautarzt. 1988;39:341-342. 45. Lozier JR, Friedlaender MH. Complications of antimalarial therapy . Int Ophthalmol Clin. 1989;29:172-178.Crossref 46. Portnoy JZ, Callen JP. Ophthalmologic aspects of chloroquine and hydroxychloroquine therapy . Int J Dermatol. 1983;22:273-278.Crossref 47. Isaacson D, Elgart M, Turner ML. Anti-malarials in dermatology . Int J Dermatol. 1982;21:379-395.Crossref 48. Koranda F. Antimalarials . J Am Acad Dermatol. 1981;4:650-655.Crossref 49. American Thoracic Society. Treatment of sarcoidosis: a statement by the Committee on Therapy Am Rev Respir Dis. 1971; 103:433-434. 50. Tanenbaum L, Tuffanelli DL. Antimalarial agents: chloroquine, hydroxychloroquine, and quinacrine . Arch Dermatol. 1980;116:587-591.Crossref 51. Kowertz MJ. The therapeutic effect of chloroquine hepatic recovery in porphyria cutaneous tarda . JAMA. 1973;223:515-519.Crossref 52. Ashton RE, Hawk JL, Magnus IA. Low-dose oral chloroquine in the treatment of porphyria cutaneous tarda . Br J Dermatol. 1984;111:609-613.Crossref 53. Rynes RI. Ophthalmologic safety of long-term hydroxychloroquine sulfate treatment . Am J Med. 1983;75( (1A) ):35-39.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Treatment of Cutaneous Sarcoidosis With Chloroquine: Review of the Literature

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1991.01680060108015
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Abstract

Abstract • Systemic corticosteroids may be either contraindicated or not efficacious in treating the cutaneous manifestations occurring in 20% to 35% of patients with systemic sarcoidosis. Chloroquine phosphate has been reported to be a valuable alternative therapy for cutaneous lesions of sarcoidosis. With a judiciously determined daily dosage and regular 6-month ophthalmologic follow-up examinations, the risk of developing retinopathy can be avoided, because the daily dosage rate rather than total dose accumulation determines the development of chloroquine-induced retinopathy. We reviewed the efficacy and safety of chloroquine and its role in the treatment of cutaneous sarcoidosis. (Arch Dermatol. 1991;127:1034-1040) References 1. Kerdel FA, Moschella SL. Sarcoidosis: an updated review . J Am Acad Dermatol. 1984;11:1-19.Crossref 2. Poe RH, Utell MJ. Diagnosis and management of pulmonary sarcoidosis . Compr Ther. 1989;15:35-42. 3. James DG. Dermatological aspects of sarcoidosis . Q J Med. 1959;28:108-124. 4. Cronin E. Skin changes in sarcoidosis . Postgrad Med J. 1970;46:507-509.Crossref 5. Sharma OP. Cutaneous sarcoidosis: clinical features and management . Chest. 1972;61:320-325.Crossref 6. Elgart ML. Cutaneous lesions of sarcoidosis . Prim Care. 1978;5:249-262. 7. Olive KE, Kataria YP. Cutaneous manifestations of sarcoidosis: relationships to other organ system involvement, abnormal laboratory measurements, and disease course . Arch Intern Med. 1985;145:1811-1814.Crossref 8. Veien NK. Cutaneous sarcoidosis: prognosis and treatment . Clin Dermatol. 1986;4:75-87.Crossref 9. O'Leary TJ, Jones G, Yip A, Lohnes D, Cohanium M, Yendt ER. The effects of chloroquine on serum 1,25-dihydroxyvitamin D and calcium metabolism in sarcoidosis . N Engl J Med. 1986;315:727-730.Crossref 10. Shaffer B, Cahn MM, Levy EJ. Sarcoidosis apparently cured by quinacrine (Atabrine) hydrochloride . Arch Dermatol. 1953; 67:640-641. 11. Klauder JV. Sarcoid of the eyelids, conjunctiva, and uveal tract treated with quinacrine hydrochloride (Atabrine dihydrochloride) . Arch Dermatol. 1953;68:474. 12. Soderstrom N. Two cases of sarcoidosis treated with mepacrine . Lancet. 1960;2:947-948.Crossref 13. Fuld H. Sarcoidosis treated with chloroquine . Lancet. 1960;2:1029-1030.Crossref 14. Morse SI, Cohn ZA, Hirsch JG, Shaedler RW. The treatment of sarcoidosis with chloroquine . Am J Med. 1961;30:779-784.Crossref 15. Hirsch JG. Experimental treatment with chloroquine . Am Rev Respir Dis. 1961;84:52-58. 16. Hunt BJ, Yendt ER. The response of hypercalcemia in sarcoidosis to chloroquine . Ann Intern Med. 1963;59:554-563.Crossref 17. Barré PE, Gascon-Barré M, Meakins JL, Goltzman D. Hydroxychloroquine treatment of hypercalcemia in a patient with sarcoidosis undergoing hemodialysis . Am J Med. 1987;82:1259-1262.Crossref 18. Adams JS, Diz MM, Sharma OP. Effective reduction in the serum 1,25-dihydroxyvitamin D and calcium concentration in sarcoidosis associated hypercalcemia with short-course chloroquine therapy . Ann Intern Med. 1989;111:437-438.Crossref 19. Davies D. Sarcoidosis treated by chloroquine . Br J Dis Chest. 1963;57:30-36.Crossref 20. Siltzbach LE, Teirstein AS. Chloroquine therapy in 43 patients with intrathoracic and cutaneous sarcoidosis . Acta Med Scand. 1964;176( (suppl 425) ):302-308.Crossref 21. Morse SI. The therapeutic effect of chloroquine in sarcoidosis . In: Turiaf J, Chabot J, eds. La Sarcoidose: Rapports de la IV Conference International . Paris, France: Mason & Co; 1967:755-771. 22. British Tuberculosis Association. Chloroquine in the treatment of sarcoidosis: a report of the research committee of the British Tuberculosis Association . Tubercle. 1967;48:257-272.Crossref 23. Krasnitz A. Chloroquine therapy in pulmonary sarcoidosis . N Y State J Med. 1967;67:1729-1736. 24. Brodthagen H, Gilg I. Hydroxychloroquine in the treatment of sarcoidosis , In: Turiaf J, Chabot J, eds. La Sarcoidose: Rapports de la IV Conference International . Paris, France: Mason & Co; 1967:764-767. 25. Brodthagen H. Chloroquine in pulmonary sarcoidosis . Lancet. 1968;1:1157.Crossref 26. Schwartz RA, Robertson DB, Tierney LM, McNutt NS. Generalized ulcerative sarcoidosis . Arch Dermatol. 1982;118:931-933.Crossref 27. Johns CJ, Schonfeld SA, Scott PP, Zachary JB, MacGregor MI. Longitudinal study of chronic sarcoidosis with low-dose maintenance corticosteroid therapy: outcome and complications . Ann N Y Acad Sci. 1986;465:702-712.Crossref 28. Verdegem TD, Sharma OP. Cutaneous ulcers in sarcoidosis . Arch Dermatol. 1987;123:1531-1534.Crossref 29. Jones E, Callen JP. Hydroxychloroquine is effective therapy for control of cutaneous sarcoidal granulomas . J Am Acad Dermatol. 1990;23:487-489.Crossref 30. Fanburg BL. Drug therapy reviews: treatment of sarcoidosis . Am J Hosp Pharm. 1979;36:351-354. 31. Dukes MNG, ed. Meyer's Side Effects of Drugs . 11th ed. Amsterdam, the Netherlands: Elsevier Science Publishers; 1988. 32. Gilman AG, Rall TW, Nies AS, Taylor P, eds. Goodman's and Gilman's: The Pharmacological Basis of Therapeutics. 8th ed. Elmsford, NY: Pergamon Press Inc; 1990. 33. Knoben JE, Anderson PO, eds. Handbook of Clinical Drug Data . 6th ed. Hamilton, Ill: Drug Intelligence Publications Inc; 1988. 34. American Medical Association. Drug Evaluations . 6th ed. Chicago, Ill: American Medical Association; 1986:1071. 35. Easterbrook M. Ocular effects and safety of antimalarial agents . Am J Med. 1988;85:23-29.Crossref 36. Fraunfelder FT. Drug-Induced Ocular Side Effects and Drug Interactions . 3rd ed. Philadelphia, Pa: Lea & Febiger; 1986:60. 37. Hobbs HE, Sorsby A, Freedman A. Retinopathy following chloroquine therapy . Lancet. 1958;2:478-480. 38. Burns RP. Delayed onset of chloroquine retinopathy . N Engl J Med. 1966;275:693-696.Crossref 39. Percival SPB, Meancock I. Chloroquine: ophthalmologic safety and clinical assessment in rheumatoid arthritis . BMJ. 1968;3:579-584.Crossref 40. Marks JS. Chloroquine retinopathy: is there a safe daily dose? Ann Rheum Dis. 1982;41:52-58.Crossref 41. Easterbrook M. Dose relationships in patients with early chloroquine retinopathy . J Rheumatol. 1987;14:472-475. 42. Olansky AJ. Antimalarials and ophthamologic safety . J Am Acad Dermatol. 1982;6:19-23.Crossref 43. Mackenzie AH. Dose refinements in long-term therapy of rheumatoid arthritis with antimalarials . Am J Med. 1983;75( (1A) ):40-45.Crossref 44. Ochsendorf FR, Runne U. Chloroquine retinopathy: preventable by monitoring the maximum daily dose . Hautarzt. 1988;39:341-342. 45. Lozier JR, Friedlaender MH. Complications of antimalarial therapy . Int Ophthalmol Clin. 1989;29:172-178.Crossref 46. Portnoy JZ, Callen JP. Ophthalmologic aspects of chloroquine and hydroxychloroquine therapy . Int J Dermatol. 1983;22:273-278.Crossref 47. Isaacson D, Elgart M, Turner ML. Anti-malarials in dermatology . Int J Dermatol. 1982;21:379-395.Crossref 48. Koranda F. Antimalarials . J Am Acad Dermatol. 1981;4:650-655.Crossref 49. American Thoracic Society. Treatment of sarcoidosis: a statement by the Committee on Therapy Am Rev Respir Dis. 1971; 103:433-434. 50. Tanenbaum L, Tuffanelli DL. Antimalarial agents: chloroquine, hydroxychloroquine, and quinacrine . Arch Dermatol. 1980;116:587-591.Crossref 51. Kowertz MJ. The therapeutic effect of chloroquine hepatic recovery in porphyria cutaneous tarda . JAMA. 1973;223:515-519.Crossref 52. Ashton RE, Hawk JL, Magnus IA. Low-dose oral chloroquine in the treatment of porphyria cutaneous tarda . Br J Dermatol. 1984;111:609-613.Crossref 53. Rynes RI. Ophthalmologic safety of long-term hydroxychloroquine sulfate treatment . Am J Med. 1983;75( (1A) ):35-39.Crossref

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Archives of Dermatology – American Medical Association

Published: Jul 1, 1991

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