Clinical Research Directory

Inclusion Criteria: * Age ≥ 18 years old \<75 years old (men and women) * Cutaneous sarcoidosis of the face (diagnosed according to the following criteria : compatible clinical appearance showing erythemato-purple, brownish or yellowish macules or papules or nodules and compatible histological appearance with a facial or extra facial skin biopsy confirming the diagnosis of sarcoidosis showing epithelioid and giganto-cellular granuloma without caseous necrosis) moderate to severe defined by: "Facial SASI" Score (Sarcoidosis Area and Severity Index) ≥ 2 and PGA (Physician's Global Assessment,0 to 10 scale) ≥ 5 * Health insurance plan coverage * Patients who never had a systemic treatment or who had at least one classical systemic treatment failure for sarcoidosis treatment * For women of childbearing age (unless post-menopausal or sterile), pregnancy test with βHCG negative. Effective contraception should be used during sirolimus treatment and for 12 weeks after stopping sirolimus * Patients who have signed a written consent Exclusion Criteria: * Severe hepatic failure (Cytolysis (ALAT)\> 3N and / or Cholestase (PAL)\> 3N) * Allergy or intolerance to sirolimus or at one of its excipients * Allergy to peanut or soybeans * Patient with a pulmonary or hepatic graft * General corticotherapy or immunosuppressive treatment (methotrexate, azathioprine, mycophenolate mofetil, cyclophosphamide, ciclosporin) in the month before the inclusion * Intra-lesional corticotherapy for less than 3 months * Biotherapy (anti-TNFa, anti-IL12/23, anti-IL17A) within 3 months preceding the inclusion * Thalidomide or other -imide treatment for less than 3 months * Cyclins treatment for less than 1 month * Topical corticosteroids or topical tacrolimus for less than 1 week * Sarcoidosis involvement of at least one organ requiring systemic treatment other than sirolimus (oral corticosteroid or systemic immunosuppressive treatment) * Cholesterolemia\> 300 mg/ dl or triglyceridemia\> 400 mg/dl * Administration of strong CYP3A4 inhibitors or inducers such as rifampicin, ketoconazole, voriconazole, telithromycin , diltiazem, verapamil, erythromycin, clarythromycin, ciclosporin * Pregnancy or breastfeeding * Active infection including tuberculosis disease * Non-controlled arterial hypertension (TAS\> 150 mmHg and / or TAD\> 100 mmHg) * Patient under guardianship or curatorship, patients deprived of freedom, under safeguarding of justice, receiving psychiatric care, under the constraint, admitted in a health or social institution for purposes other than those of research * Patient with cancer (except cutaneous basal cell carcinoma or in situ cervical cancer) * Risk of patient bad compliance * Grapefruit or grapefruit juice consumption during the treatment duration * Patients with fructose intolerance, galactose intolerance, glucose-galactose malabsorption, insufficiency in sucrase-isomaltase or Lapp lactase