Review of treatment for discoid lupus erythematosus.

Discoid lupus erythematosus (DLE) is a chronic cutaneous disease characterized by inflammatory plaques that, in the absence of prompt diagnosis and treatment, may lead to disfiguring scarring and skin atrophy. However, there is limited evidence for which treatments are most effective. Currently, no medications have been approved specifically for the treatment of DLE. Many of the drugs described in the literature were developed for use in other immune disorders. This review will summarize current therapeutic options for DLE and their supporting evidence with discussion of prevention, topical measures, physical modalities, and systemic therapies, including newer potential therapies.

Successful treatment with topical tacrolimus in four cases of discoid lupus erythematosus.

Discoid lupus erythematosus (DLE), a cutaneous form of lupus erythematosus, is characterized as atrophic and scaly erythema and the lesions are often refractory to a wide range of topical or systemic therapies. Herein, we present four cases of DLE that were successfully treated with topical tacrolimus. Tacrolimus ointment (0.1%) was applied to DLE lesions twice daily and the erythematous plaques readily diminished after 4-8 weeks. Adverse effects, such as burning sensation or irritations, were not observed. These results indicate that topical tacrolimus might be an effective and alternative treatment to control DLE.

Lupus erythematosus tumidus in systemic lupus erythematosus: novel association and possible role of early treatment in prevention of discoid lupus erythematosus.

Skin involvement in systemic lupus erythematosus (SLE) occurs in varied forms. Lupus erythematosus tumidus (LET) is not known to occur with SLE. In our patient presented below, LET occurred in a patient with SLE. Some of the lesions progressed to scarring discoid lesions, while others responded very well to hydoxychloroquine treatment. We, as rheumatologists, are not very aware of this entity, which is so amenable to prevention and treatment if recognized correctly.

A study of physical light screening agents.

In those photodermatoses in which the action spectrum involves wavelengths outside the short ultraviolet (i.e. is greater than 320 nm) little protection can be obtained against long UV (is greater than 320 nm) by the application of chemical light screening agents. An action spectrum involving wavelengths is greater than 320 nm is a common occurrence and may necessitate the additional provision of protection from a physical light screening agent. Such a physical agent is titanium dioxide and in a study of its use in a variety of formulations using in vitro techniques it was shown to be effective throughout the wavelengths 400-700 nm. It was also shown to have a satisfactory protective capacity in those photodermatoses in which the action spectrum involves wavelength peaks 365 nm (335-395 nm) and 400 nm (370-430 nm). It also has a reasonable cosmetic acceptability provided care is taken to incorporate in the formulations colouring agents which can be varied to suit the individual patient.