[Capecitabine-induced subacute cutaneous lupus: a case report]. / Lupus cutané subaigu induit par la capécitabine : un cas.

BACKGROUND: More than 100 drugs have been registered as inducing subacute cutaneous lupus erythematosus (SCLE). Recently, some types of chemotherapy have also been incriminated. If SCLE develops in a setting of neoplasia, two possibilities should be considered: it is either a paraneoplastic syndrome or it is caused by the chemotherapy, thus calling for important decisions on the benefit/risk of stopping potentially effective medication. We report a case of SCLE induced by Xeloda (capecitabine). PATIENTS AND METHODS: A 50-year-old female patient consulted with an annular erythematosquamous and pruriginous eruption, predominantly on areas of the body exposed to sunlight, occurring 4 months after the initiation of capecitabine for advanced colon cancer. She had presented systemic lupus erythematosus (SLE) for many years, which was not treated, was not progressive and had no cutaneous manifestations. The appearance of the cutaneous lesions, positivity for anti-SSA antibodies and the histological aspect led to diagnosis of SCLE. The lesions were resistant to treatment with hydroxychloroquine and systemic corticosteroids, but disappeared after discontinuation of capecitabine, suggesting chemotherapy-induced SCLE. DISCUSSION: Some types of chemotherapy such as capecitabine may reveal or induce SCLE lesions, whether or not there is a previous history of SLE. Cases of chemotherapy-induced cutaneous lupus reported to the French pharmacovigilance agency are rare, but this side effect must be recognised due to the constantly rising use of this type of anticancer agent.

[Effect of smoking on the effectiveness of antimalarial drugs for cutaneous lesions of patients with lupus: assessment in a prospective study]. / Influence du tabagisme sur l'efficacité des antipaludéens de synthèse (APS) sur les lésions cutanées de sujets atteints de lupus: évaluation à travers une étude prospective.

PURPOSE: Smoking has been involved in the failure of antimalarial therapy in patient with chronic or subacute erythematosus lupus. METHODS: We report a prospective study of 26 patients with chronic, subacute or systemic erythematosus lupus who were treated with antimalarials. Several variables including smoking are compared in responders and non-responders. RESULTS: Despite the reduced number of patients study that does not permit to allow significative results, it seems that among responders and non-responders, in other respects comparables, there is no difference in the presence of smoking, its quantity or its duration. CONCLUSION: The significance of molecular interactions between some components of tobacco and antimalarials have still to be established.