chronic cutaneous lupus erythematosus difficult management
DESCRIPTION
Chronic Cutaneous Lupus Erythematosus Difficult ManagementTRANSCRIPT
Chronic Cutaneous Lupus Erythematosus
What would you propose as therapeutic option in this
case?
Chronic cutaneous LE
63-year-old women. Diagnosed of Chronic Cutaneous
Lupus Erythematosus in 2006.
Chronic cutaneous LE
Physical examination• Smooth, non scarring, pink to
violaceous papules or plaques without evidence of surface change.
• Loceted on the face and upper extremities.
Chronic cutaneous LE
Skin Biopsy revealed:• A superficial and deep lymphocytic
infiltration in a perivascular and periadnexal distribution.
• Dermal interstitial mucin deposition and focal or absent dermoepidermal junction involvement.
Chronic cutaneous LE
Laboratory examinations: Antinuclear antibodies: 1/40.
Homogeneous. Anti SSA/RO: positive.
Chronic cutaneous LE
Chronic cutaneous LE
Chronic cutaneous LE
Treatment was prescribed without improvement in 2006:
Topical tacrolimus, pimecrolimus and corticosteroids.
Hydroxychloroquine at a dose of 400-600 mg/d for 6 months.
Prednisone at a dose of 0,5 mg/kg/d for 3 months.
Chronic cutaneous LE 2007
Chronic cutaneous LE 2007
Chronic cutaneous LE
Treatment was prescribed without improvement in 2007
Dapsone at a dose of 100 mg/d for 8 months.
Chronic cutaneous LE 2008
Chronic cutaneous LE
Treatment was prescribed without improvement in 2008-2009.
Methotrexate at a dose of 15mg at week for 4 months.
Chronic cutaneous LE 2009
What would you propose as therapeutic
option in this case?
Chronic cutaneous LE
F.Peral Rubio, M.D.
Department of Dermatology Complejo Hospitalario Universitario, Badajoz, Spain.