[Treatment of sarcoid dactylitis with brief intravenous perfusion of high-dose methylprednisolone].

Sarcoid phalangeal involvement is a rare complication of a chronic disease process. Some forms pose difficult therapeutic problems, as steroids, even at high doses, do not always arrest the destructive changes. We report 3 cases of sarcoid phalangeal disease treated by intravenous infusion of 1 g of Methylprednisolone given in 3 hours on 3 consecutive days at monthly intervals for 4, 5, 7 and 8 months, respectively. Clinical improvement was rapid, constant and of excellent quality. The concentrations of the angiotensin converting enzyme returned to normal but Gallium 67 scintigraphy did not seem to be a helpful follow-up investigation. The radiological lesions were observed to regress during treatment in 1 case. Tolerance was excellent in the absence of maintenance steroid therapy. Further studies are required to assess the long term outcome.