Treatment of Subacute Cutaneous Lupus Erythematosus with Localized Skin Lesions
This protocol covers the management of subacute cutaneous lupus erythematosus (SCLE) in patients presenting with localized cutaneous lupus erythematosus skin lesions.
Clinical Scenario
The patient presents with localized cutaneous lupus erythematosus skin lesions. Topical agents are a recognised cornerstone for this localised presentation across CLE subtypes, though systemic therapy may also be required.
Treatment Approach (partial)
Systemic management in this setting involves an immunosuppressive agent, used preferably in combination with antimalarials. The complete agent selection, escalation pathway, and any alternatives are detailed in the full protocol.
References
- Topical corticosteroids are the mainstay in the treatment of localized CLE being effective in all subtypes (Figure 1), but only few controlled studies have been published proving their efficacy.
- We recommend MMF as third-line treatment in refractory CLE patients, preferably in addition to antimalarials.
- We recommend 2 x 500 mg MMF per day as starting dose that can be increased up to 3 g per day depending on the clinical response.
- We suggest MPA as an alternative treatment to MMF.