Hydroxychloroquine enhanced urticarial reaction in a patient with discoid lupus erythematosus

Abstract

Discoid lupus erythematosus (DLE) is an autoimmune disorder that usually occurs on sun exposed areas. We describe a case of a 31-year-old man with reddish-purple, atrophic plaques on the nose and the bilateral cheeks. Histopathologic and direct immuneofluorescent studies confirmed DLE diagnosis. The skin lesion had been previously resistant to topical clobetasol propionate 0.05% and tacrolimus 0.1% since 2012, and were treated with oral hydroxychloroquine (HCQ) (300 mg daily). Two weeks later, the diarrhea happened frequently as side effects. Then, the decreased HCQ 200 mg daily improved the diarrhea moderately. The patient who had a history of urticaria also complained about urticarial reaction much more frequently 3 weeks later more than the start, which was improved very much by epinastine (10 mg daily) administration. Cutaneous lupus erythematsus disease area and severity index (CLASI) activity score improved from 11 to 5 for 3 months.

Combination use of triamcinolone acetonide and immunotherapy as a new therapeutic option in alopecia totalis

“…Various treatments are known in AT and alopecia universalis (AU), and although however certain treatments have shown significant hair regrowth, no treatment is completely effective [4] . Recently, the efficacy of hydroxychloroquine [5,6] in the treatment of AT has been reported [7] but its use for extensive alopecia areata is still controversial [8] . Tofatinib is also reported to show efficacy in severe AA including AT and AU [9] .…”

Hydroxychloroquine for the treatment of cutaneous lupus erythematosus

“…Most of the drug eruptions developed within 4 weeks after the start of HCQ administration and disappeared within a few weeks after discontinuation. It is not necessary to decrease or discontinue for patients with drug eruption up to moderate diseases that do not other organs' problems [27,28] .…”

Hydroxychloroquine in lupus erythematosus, a new horizon of the old drug

“…In this volume 1 issue 3, Japanese doctors present a discoid lupus erythematosus (DLE) patient well treated with hydroxychloroquine (HCQ) ( Figure 1), in whom urticarial reaction was transiently worsened [1] . This case has two underlying aspects especially for Japanese doctors, which is probably shared with Asian doctors.…”