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.