ABSTRACT
Extrathoracic Sarcoidosis Guidelines for the use of corticosteroids in extrathoracic disease are given in Fig. 6. Neuro sarcoidosis, cardiac sarcoidosis, ocular sarcoidosis, hypercalcemia, and upper airway involvement with sarcoidosis almost always call for systemic corticosteroid therapy. With the exception of hypercalcemia (which responds well to therapy), a higher initial dose of corticosteroids (i.e., 60-80 mg of prednisone per day) is often used initially to treat these manifestations of sarcoidosis. Prolonged treatment of these manifestations of the disease is often needed. Skin involvement and lymph node, spleen, and parotid enlargement re sulting in significant symptoms can often be treated with lower doses of corticosteroids, such as 20 mg daily, followed by tapering to 20 mg every other day. Mild, asymptomatic liver involvement does not require therapy.
