Management of skin sarcoidosis with minocycline monotherapy

A 46‐year‐old woman with severe skin sarcoidosis, mainly on the back of the trunk, persisting for >15 years, was followed up without systemic treatment. In 2014, she was started on minocycline monotherapy owing to worsening of the skin sarcoid lesions. Surprisingly, after approximately 1 year of the monotherapy, nearly all skin lesions resolved with only light residual scars, despite the poor efficacy of the monotherapy for pulmonary sarcoidosis. The patient's serum angiotensin‐converting enzyme levels also decreased to the normal range. The presence of Propionibacterium acnes was confirmed when a retrospectively immunostained epithelioid granuloma, obtained from skin biopsy, demonstrated staining with monoclonal antibodies specific for P. acnes. Minocycline monotherapy, thus, appears to be a possible treatment modality for skin sarcoidosis.