Successful treatment of cutaneous sarcoid by photodynamic therapy with minimal discomfort using a fractionated dosing regime.

We report the case of a 42-year-old lady with an 8-year history of a persistent tumid plaque on her forehead. Investigations and presentation were consistent with cutaneous sarcoid with no systemic involvement. Multiple topical and oral treatments had been ineffective. She received seven sessions of 5-aminolaevulinic acid photodynamic therapy (PDT) over the course of 16 months. Each treatment was delivered in discontinuous and fractionated time intervals. Improvement was seen after the first treatment and continued with subsequent treatments. She found the treatment almost painless and was pleased with the cosmetic outcome. We conclude that PDT is a useful therapy in the treatment of facial cutaneous sarcoid. Fractionated exposure may allow the treatment to be less painful and therefore better tolerated.