Rapid response to treatment with thalidomide in an adolescent with generalized discoid lupus erythematosus

Tran, Benjamin; Abyaneh, Mohammad-Ali Yazdani; Wu, Julia

doi:10.1111/pde.14067

Cited by 4 publications

(8 citation statements)

References 4 publications

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“…In case reports, treatment with HCQ as monotherapy or in combination with other treatments resulted in improvement in alopecia secondary to variants of CLE, including DLE, LEP, and tumid LE. 12,20,28,30,44,[57][58][59] It is important to note that HCQ above a dose regimen of 5 mg/kg is associated with significant ocular toxicity and should be avoided. 60…”

Section: Corticosteroids and Antimalarialsmentioning

confidence: 99%

“…50,82,83 Thalidomide has also been reported to significantly improve alopecia associated with DLE in a pediatric patient. 59 However, its use is limited by severe side effects, including teratogenicity, peripheral neuropathy, and thrombosis, as well as frequent relapses after withdrawal of therapy. 42,50,[82][83][84] In several non-comparative trials and observational studies, lenalidomide proved efficacious in treating refractory CLE, without inducing or worsening peripheral neuropathy.…”

Section: Dapsonementioning

confidence: 99%

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Recent Insight on the Management of Lupus Erythematosus Alopecia

Desai¹,

Miteva²

2021

CCID

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Lupus erythematosus (LE) is a chronic autoimmune condition with a wide spectrum of clinical presentations. Alopecias, both non-scarring and scarring, frequently occur in the context of LE and can assume several different patterns. Furthermore, alopecia occurring with LE may be considered LE-specific if LE-specific features are present on histology; otherwise, alopecia is considered non-LE-specific. Non-scarring alopecia is highly specific to systemic LE (SLE), and therefore has been regarded as a criterion for the diagnosis of SLE. Variants of cutaneous LE (CLE), including acute, subacute, and chronic forms, are also capable of causing hair loss, and chronic CLE is an important cause of primary cicatricial alopecia. Other types of hair loss not specific to LE, including telogen effluvium, alopecia areata, and anagen effluvium, may also occur in a patient with lupus. Lupus alopecia may be difficult to treat, particularly in cases that have progressed to scarring. The article summarizes the types of lupus alopecia and recent insight regarding their management. Data regarding the management of lupus alopecia are sparse and limited to case reports, and therefore, many studies including in this review report the efficacy of treatments on CLE as a broader entity. In general, for patients with non-scarring alopecia in SLE, management is aimed at controlling SLE activity with subsequent hair regrowth. Topical medications can be used to expedite recovery. Prompt treatment is crucial in the case of chronic CLE due to potential for scarring and irreversible damage. First-line therapies for CLE include topical corticosteroids and oral antimalarials, with or without oral corticosteroids as bridging therapy. Second and third-line systemic treatments for CLE include methotrexate, retinoids, dapsone, mycophenolate mofetil, and mycophenolate acid. Additional topical and systemic medications as well as physical modalities used for the treatment of lupus alopecia and CLE are discussed herein.

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Section: Corticosteroids and Antimalarialsmentioning

confidence: 99%

Section: Dapsonementioning

confidence: 99%

Recent Insight on the Management of Lupus Erythematosus Alopecia

Desai¹,

Miteva²

2021

CCID

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“…However, relapses after drug withdrawal were developed by nearly all patients, even if less severe (65). Subsequent case series or small sized studies reported similar results with doses of mainly 50-100 mg daily (63,(65)(66)(67)(68)(69).…”

Section: Thalidomidementioning

confidence: 68%

An update on the management of refractory cutaneous lupus erythematosus

et al. 2022

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Management of cutaneous lupus erythematosus (CLE) involves a combination of preventive measures, topical and systemic drugs, fairly similar for the different subtypes. Although guidelines exist, to date, no specific drugs have been specifically licensed for CLE. Antimalarials remain the first-line systemic treatment, but many patients do not respond, making refractory lupus a challenge for clinicians. The choice of alternative medication should be based on effectiveness, safety and cost. Most of the available drugs for CLE have been adapted from systemic lupus erythematosus (SLE) treatment but the existing literature is limited to small studies and evidence often lacks. As knowledge of pathogenesis of both CLE and SLE is improving, promising new therapies are emerging. In this review, we discuss the available medications, focusing on the novelties under development for CLE.

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“…Thalidomide is an immunomodulator treatment used in multiple inflammatory disorders. 6 Its use in several photodermatosis, particularly lupus erythematous 7 and actinic prurigo, 8…”

Section: Discussionmentioning

confidence: 99%

“…Thalidomide is an immunomodulator treatment used in multiple inflammatory disorders 6 . Its use in several photodermatosis, particularly lupus erythematous 7 and actinic prurigo, 8 had shown good results. Its mode of action in the case of CAD is poorly understood.…”

Section: Discussionmentioning

confidence: 99%