Glucocorticoids combined with tofacitinib for systemic sarcoidosis with rash as initial symptom: a case report

Systemic sarcoidosis is a granulomatous disease involving multiple organs and systems. A 36-year-old woman was admitted due to multiple nodules of the trunk for 4 months. Upon admission， laboratory and auxiliary examinations were performed. A biopsy specimen revealed multiple nodules in the superficial dermis， which were composed of cells with abundant cytoplasm， large cell body and round or oval nuclei. PET/CT revealed systemic multiple lymph node enlargement complicated with active metabolism. She was eventually diagnosed with systemic sarcoidosis. After combined treatment of methylprednisolone， hydroxychloroquine and tofacitinib for 4 months， the skin lesions were significantly mitigated and no new skin lesions were found. This case prompts that Janus kinase inhibitors can be used to replace conventional immunosuppressants with reproductive toxicity for systemic sarcoidosis patients of reproductive age.