Cutaneous lupus erythematosus: A review of the literature

Abstract

Knowledge with regard to the pathogenesis of lupus erythematosus has progressed rapidly over the past decade, and with it has come promising new agents for the treatment of cutaneous lupus erythematous (CLE). Classification of CLE is performed using clinical features and histopathologic findings, and is crucial for determining prognosis and choosing therapeutic options. Preventative therapy is critical in achieving optimal disease control, and patients should be counseled on sun-safe behavior and smoking cessation. First-line therapy includes topical corticosteroids and calcineurin inhibitors, with antimalarial therapy. Traditionally, refractory disease was treated with oral retinoids, dapsone, and other oral immunosuppressive drugs, but new therapies are emerging with improved side effect profiles and efficacy. Biologic agents, such as belimumab and ustekinumab, have been promising in case studies but will require larger trials to establish their role in routine therapy. Other novel therapies that have been trialed successfully include spleen tyrosine kinase inhibitors and fumaric acid esters. Finally, new evidence has been published recently that describes safer dosing regimens in thalidomide and lenalidomide, both effective medications for CLE. Given the chronic disease course of CLE, long-term treatment-related side effects must be minimized, and the introduction of new steroid-sparing agents is encouraging in this regard.

Atypical dermatophytosis in a case of systemic lupus erythematosus

“…Apart from associated immunealterations due to the disease and the treatment, drug interactions with antifungal therapy is a major concern. Griseofulvin and terbinafine can trigger or worsen SLE, hence they are better avoided [6,7]. Itraconazole was chosen since it does not have interactions with azathioprine and hydroxychloroquine sulphate, and is known to induce or worsen lupus erythematosus.…”

Penggunaan Ester Asam Fumarat Oral Dalam Pengobatan Kasus Dermatologi

“…Dengan konfirmasi lebih lanjut melalui uji coba terkontrol secara acak, FAE mungkin merupakan pengobatan yang aman dan efektif pada mereka dengan CLE yang sulit disembuhkan. [29,30]…”

“…Efek samping yang paling umum diamati termasuk masalah gastrointestinal (termasuk nyeri lambung dan kerongkongan), diare, pembilasan, mual, dan kram perut. [30] Efek samping ini, terutama efek gastrointestinal, sering dilaporkan pada awal pengobatan antara minggu 4 dan 12. Kemerahan cenderung dialami ½ hingga 2 jam setelah meminum tablet dan akan bertahan hingga ½ jam.…”

“…Pada sebagian besar pasien yang mengalami respon yang merugikan, efek samping menghilang atau berkurang setelah mengurangi atau menghentikan pengobatan FAE. [3,30] Selain itu, beberapa pasien telah mengalami perubahan hematologis dengan FAE termasuk: leukopenia sementara, limfopenia, dan eosinofilia. [33] Sejumlah pasien juga mengalami peningkatan enzim hati, trigliserida, kolesterol, proteinuria, dan serum kalium dan kreatinin.…”

Múltiplas manifestações orais em lúpus eritematoso cutâneo

“…É causada pela interação entre fatores genéticos, ambientais, hormonais e étnicos e apresenta maior incidência em mulheres na metade da vida adulta, em qualquer faixa etária e etnia. 1 O lúpus eritematoso cutâneo pode ser classificado como lúpus eritematoso cutâneo agudo (LECA), lúpus eritematoso cutâneo subagudo (LECS) e lúpus eritematoso cutâneo crônico (LECC). 2 LECC é uma doença que se manifesta principalmente como placas avermelhadas na pele, as quais podem ser únicas ou múltiplas e tendem a deixar cicatrizes e pigmentação quando desaparecem.…”