Treatment of Discoid Lupus Erythematosus

Lo, Jacob S.; Berg, Robert; Tomecki, Kenneth J.

doi:10.1111/j.1365-4362.1989.tb04599.x

Cited by 45 publications

(18 citation statements)

References 130 publications

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“…1,2,42,73,74 In general, adverse effects are less likely with hydroxychloroquine, and thus this agent is usually tried first. Prior to initiating therapy, a baseline ophthalmologic examination should be conducted, and patients who smoke should be encouraged to stop or at least decrease their habit, as cigarette smoking has been shown to reduce therapeutic responsiveness in a dose-dependent fashion.…”

Section: Discoid Lupus Erythematosusmentioning

confidence: 99%

Update on primary cicatricial alopecias

Ross

Tan

Shapiro

2005

Journal of the American Academy of Dermatology

254

323

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Section: Discoid Lupus Erythematosusmentioning

confidence: 99%

Update on primary cicatricial alopecias

Ross

Tan

Shapiro

2005

Journal of the American Academy of Dermatology

254

323

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“…Based on clinical experience, antimalarial drugs are considered to be the first option for treatment of these patients (4). When a safe dosage of antimalarial drugs is used, the side effects are rare and include retinopathy, corneal deposition, disturbance of visual accommodation, nausea, vomiting, urticaria, hair discoloration, skin and mucosal hyperpigmentation, headache, tinnitus, dizziness, and myopathy, among others (5,6). Unfortunately, not all SLE patients with cutaneous lesions show a good response to antimalarial drugs.…”

Section: Lupus Erythematosus (Le) Is An Autoimmune Disease That Can Ementioning

confidence: 99%

Double‐blind, randomized, controlled clinical trial of clofazimine compared with chloroquine in patients with systemic lupus erythematosus

Bezerra¹,

Vilar²,

Neto³

et al. 2005

Arthritis & Rheumatism

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Objective. To evaluate the efficacy of clofazimine (CFZ) compared with chloroquine diphosphate (CDP) for the treatment of cutaneous involvement in systemic lupus erythematosus (SLE).Methods. A prospective, randomized, controlled, double-blind clinical trial was carried out in SLE patients with active cutaneous lesions, of whom 16 were randomized to receive CFZ at 100 mg/day and 17 received CDP at 250 mg/day for 6 months. All drugs had a similar appearance to avoid identification. Both groups received broad-spectrum sunscreens twice a day and the prednisone dose was kept stable during the study. Cutaneous lesions were evaluated by 2 blinded observers at baseline and at months 1, 2, 4, and 6.Results. Thirty-three patients were randomized to a treatment group, of whom 27 completed 6 months of treatment. The groups were homogeneous and comparable in terms of demographic and clinical characteristics. Five CFZ-treated patients and 1 CDP-treated patient (P ‫؍‬ 0.15) dropped out due to development of severe lupus flare. At the end of the study, 12 CFZtreated patients (75%) and 14 CDP-treated patients (82.4%) had complete or near-complete remission of skin lesions; intention-to-treat analysis showed no significant difference in the response rates between groups. Side effects, mainly skin and gastrointestinal events, were frequent in both groups, but no patients had to discontinue their treatment.Conclusion. These findings suggest that CFZ is equally as effective as CDP in controlling cutaneous lesions in SLE patients. However, we cannot exclude the possibility that the CFZ itself could be the cause of systemic lupus flare. Lupus erythematosus (LE) is an autoimmune disease that can exclusively affect the skin (cutaneous LE [CLE]) or can affect other systems as well (systemic LE [SLE]). Cutaneous lesions are classified as either specific or nonspecific. Lupus-specific cutaneous lesions are divided into acute, subacute, and chronic. Acute CLE includes malar and generalized maculopapular rashes. Subacute CLE includes the annular-polycyclic and papulosquamous (psoriasiform) variants. Chronic CLE includes discoid lupus erythematosus, lupus profundus, and LE tumidus, among others. Of the nonspecific LE cutaneous lesions, Raynaud's phenomenon, bullous LE, and vasculitic lesions are most common (1-3).In the literature, there are no reports of controlled, randomized clinical trials of a treatment strategy for SLE patients with cutaneous lesions. Based on clinical experience, antimalarial drugs are considered to be the first option for treatment of these patients (4). When a safe dosage of antimalarial drugs is used, the side effects are rare and include retinopathy, corneal deposition, disturbance of visual accommodation, nausea, vomiting, urticaria, hair discoloration, skin and mucosal hyperpigmentation, headache, tinnitus, dizziness, and myopathy, among others (5,6). Unfortunately, not all SLE patients with cutaneous lesions show a good response to antimalarial drugs. Treatment of the refractory cases includes use of thalidomide...

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“…18 Hemolysis is reported in individuals who are deficient in the enzyme glucose-6-phosphate-dehydrogenase. Hydroxychloroquine has, on rare occasions, caused toxic psychosis when used for the treatment of discoid lupus.…”

Section: Antimalarialsmentioning

confidence: 99%

Early Diagnosis and Treatment of Discoid Lupus Erythematosus

Panjwani

2009

The Journal of the American Board of Family Medicine

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Discoid lupus erythematosus is a chronic dermatological disease that can lead to scarring, hair loss, and hyperpigmentation changes in skin if it is not treated early and promptly. It has a prolonged course and can have a considerable effect on quality of life. Early recognition and treatment improves the prognosis. The diagnosis is usually made by clinical examination. In some cases histopathology may be required to confirm the diagnosis. The histology is that of an inflammatory interface dermatosis. There is insufficient evidence for which treatment is most effective.

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Treatment of Discoid Lupus Erythematosus

Cited by 45 publications

References 130 publications

Update on primary cicatricial alopecias

Update on primary cicatricial alopecias

Double‐blind, randomized, controlled clinical trial of clofazimine compared with chloroquine in patients with systemic lupus erythematosus

Early Diagnosis and Treatment of Discoid Lupus Erythematosus

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