Treatment of Subacute Cutaneous Lupus Erythematosus with Severe or Widespread Skin Lesions
When subacute cutaneous lupus erythematosus presents with severe or widespread skin involvement, carries a risk of scarring, or raises concern for progression to systemic disease, a structured systemic treatment approach is required.
Clinical Scenario
Severe or widespread cutaneous lupus erythematosus skin lesions, or risk of scarring, or risk of development of systemic disease.
Treatment Approach — Partial Overview
In this scenario, the treatment approach involves thalidomide — the full selection criteria, combination strategy, and clinical algorithm are available in the complete protocol.
References
- We recommend antimalarials as first-line and long-term systemic treatment in all CLE patients with severe or widespread skin lesions, in particular in patients with the risk of scarring and development of systemic disease.
- In severe or widespread active CLE lesions, systemic corticosteroids are recommended as first-line treatment in addition to antimalarials.
- We recommend thalidomide for selected refractory CLE patients, preferably in addition to antimalarials.
- We suggest a starting dose of 100 mg per day and, after clinical effectiveness, to taper to a minimum dose.
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