Topical niacinamide (Nicotinamide) treatment for discoid lupus erythematosus (DLE): A prospective pilot study

Abstract

Background Cutaneous lupus erythematosus is an umbrella term for a group of autoimmune connective tissue disorders affecting the skin. Discoid lupus erythematosus (DLE) is the chronic condition and most common form of cutaneous lupus erythematosus. Aims Current therapies of DLE are challenging and not completely satisfactory, highly expensive, off‐label, or poorly available (like antimalarials due to COVID‐19 outbreaks). Nicotinamide, also called niacinamide, is a water‐soluble form of vitamin B3 (niacin). Its multiple effects let us think that nicotinamide could be a therapy for lupus‐associated skin lesions. Methods We performed a prospective randomized double‐blind clinical trial on 60 subjects diagnosed with Discoid lupus erythematosus using topical Nicotinamide 2% and 4% preparations in form of cream and gel on skin and scalp lesions. Control group was included using only cream/gel base as placebo control. Results Obtained data showed that topical Nicotinamide can be used for the treatment of DLE as adjuvant to other treatment regimens with good cosmetic results and minimal side effects. Topical 4% Nicotinamide is superior to 2% preparation in response but associated with a higher incidence of irritation. Conclusion Topical Nicotinamide can be used for the treatment of DLE as an adjuvant to other treatment regimens with good cosmetic results and minimal side effects. Further trials with long‐term therapy, follow‐up period, and bigger sample sizes are required.

Hypothyroidism, skin changes, and methods of skin care

“…The subjects were instructed on how to deal with side effects. It was recommended to wash the application site 2 hours after application of the preparation [32].…”