Cutaneous sarcoidosis in the precision medicine era

Sarcoidosis is an inflammatory disorder of unknown origin that belongs to the group of granulomatous diseases. It is characterized by the development of typical non-caseating granulomas in affected organs, which may progress to fibrosis and organ dysfunction. The lungs are most frequently involved, followed by the lymph nodes and skin. Cutaneous sarcoidosis presents with highly variable clinical forms and disease courses. Skin involvement may precede systemic manifestation, occur simultaneously, or develop later in the disease. The treatment of cutaneous sarcoidosis often poses a challenge for physicians, as therapeutic responses vary widely depending on patient heterogeneity and lesion morphology. Currently, systemic or topical glucocorticoids remain the gold standard of therapy, yet their efficacy is inconsistent and long-term use is limited by side effect. In contrast to other chronic inflammatory conditions, targeted therapies for sarcoidosis are still scarce. However, recent advances in sarcoidosis research are paving the way for novel treatment options, including mTOR inhibition or targeting of the JAK/STAT pathway. A deeper understanding of disease mechanisms is expected to facilitate the development of more specific and effective therapies for cutaneous sarcoidosis in the future.