Management of cutaneous lupus erythematosus with low-dose methotrexate: indication for modulation of inflammatory mechanisms.
There is no consensus about an effective and safe treatment for patients with cutaneous lupus erythematosus (LE) who are refractory to antimalarials and/or low-dose oral glucocorticosteroids. Therefore, we retrospectively analyzed the clinical data and laboratory findings of 12 patients who received weekly administrations of 10-25 mg methotrexate (MTX). Previous treatment with antimalarials and/or glucocorticosteroids was not effective or had to be withdrawn because of side effects. Of 12 patients, ten showed improvement of their skin lesions; two patients did not respond to low-dose MTX; two patients cleared rapidly, and five other patients had long-lasting remissions of 5-24 months after stopping MTX treatment. A reduction of circulating autoantibodies was detected in five patients. In all patients, MTX was well tolerated subjectively and objectively. Weekly low-dose MTX is useful for the treatment of cutaneous LE, particularly in those cases which need long-term treatment and/or do not respond to standard therapeutic regimens.
Department of Dermatology, University of Bonn, Germany.
I B
IB
Boehm
G A
GA
Boehm
R
R
Bauer
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001323:Autoantibodies / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000188:drug therapy* / Q000276:immunology; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D001323:Autoantibodies; D008727:Methotrexate