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While corticosteroids remain the first line of treatment, tumour necrosis factor alpha (<jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u2010\u03b1) inhibitors have been investigated as one potential steroid sparing treatment for sarcoidosis. <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u2010\u03b1 is one of many components involved in the formation of granulomas in sarcoidosis. While there have been larger scale studies of biologic <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u2010\u03b1 inhibition in systemic sarcoidosis, studies in cutaneous disease are limited. Paradoxically, in some patients treated with biologic <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u2010\u03b1 inhibitors for other diseases, treatment can induce the development of sarcoidosis. In the light of this complexity, we discuss the role of <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u2010\u03b1 in granuloma formation, the therapeutic role of <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u2010\u03b1 inhibition and immunologic abnormalities following treatment with these <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content>\u2010\u03b1 inhibitors including drug\u2010specific alterations involving interferon\u2010\u03b3, lymphotoxin\u2010\u03b1, <jats:styled-content style=\"fixed-case\">TNF<\/jats:styled-content> receptor 2 (<jats:styled-content style=\"fixed-case\">TNFR<\/jats:styled-content>2) and T\u2010regulatory cells.<\/jats:p>","DOI":"10.1111\/jdv.13246","type":"journal-article","created":{"date-parts":[[2015,8,26]],"date-time":"2015-08-26T10:24:49Z","timestamp":1440584689000},"page":"2104-2111","source":"Crossref","is-referenced-by-count":72,"title":["<scp>TNF<\/scp>\u2010\u03b1: a treatment target or cause of sarcoidosis?"],"prefix":"10.1111","volume":"29","author":[{"given":"K.T.","family":"Amber","sequence":"first","affiliation":[{"name":"Department of Dermatology University of California Irvine Health Irvine CA USA"},{"name":"Department of Internal Medicine MacNeal Hospital Berwyn IL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Bloom","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Mrowietz","sequence":"additional","affiliation":[{"name":"Psoriasis\u2010Center Department of Dermatology, Venereology and Allergology University Medical Center Schleswig\u2010Holstein Kiel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Hertl","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology Philipps University Marburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,8,26]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0413"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009096"},{"key":"e_1_2_7_4_1","first-page":"173","article-title":"Incidence of clinically identified sarcoidosis in a northwest United States population","volume":"13","author":"Reich JM","year":"1996","journal-title":"Sarcoidosis Vasc Diffuse Lung Dis"},{"key":"e_1_2_7_5_1","first-page":"29","article-title":"Sarcoidosis: epidemiology and prognosis. 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