Managing lupus profundus when a patient is pregnant or breastfeeding calls for specific, evidence-based guidance. Active disease in this setting requires a treatment approach that accounts for the clinical situation.
This protocol applies to patients with active lupus profundus who are currently pregnant or breastfeeding. Guidance is available for this specific population, addressing how to approach active disease safely in this setting.
First-line management involves topical therapy applied to skin lesions, with considerations around the duration of use. The complete protocol specifies which topical options apply, how they are sequenced, and what guides the choice between them — none of which is fully detailed here.
In active disease during pregnancy or breastfeeding, we recommend HCQ as first line treatment for CLE at usual dosage.
We recommend topical corticosteroids as first-line treatment for a time limited up to some weeks in all CLE lesions.
In active, oedematous CLE lesions, particularly on the face, we recommend calcineurin inhibitors (0.1% tacrolimus ointment) as an alternative first-line or as a second-line topical treatment option.
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