This protocol addresses the management of subacute cutaneous lupus erythematosus (SCLE) when it presents as localized cutaneous lupus erythematosus (CLE) skin lesions — a defined sub-population requiring a structured, evidence-based therapeutic approach.
The patient has localized cutaneous lupus erythematosus skin lesions. Topical treatment is the established mainstay for localized CLE, with evidence supporting efficacy across subtypes; however, certain presentations require escalation to systemic therapy.
When systemic treatment is indicated, the regimen involves specific agents from the retinoid class or dapsone, guided by the individual patient's response profile and tolerability — preferably used in combination with antimalarial therapy.
Topical corticosteroids are the mainstay in the treatment of localized CLE being effective in all subtypes, but only few controlled studies have been published proving their efficacy.
We recommend retinoids as second-line systemic treatment in selected CLE patients unresponsive to other treatments, preferably in addition to antimalarials.
We recommend dapsone as second-line treatment in refractory CLE, preferably in addition to antimalarials.
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