Management of "refractory" skin disease in patients with lupus erythematosus.
Skin disease in patients with lupus erythematosus can be subdivided into two broad categories-those lesions that, when biopsied, demonstrate an interface dermatitis and those that do not demonstrate an interface dermatitis. The skin lesions that are represented by the interface dermatitis include discoid lupus erythematosus (DLE), subacute cutaneous lupus erythematosus (SCLE), and acute cutaneous lupus erythematosus. Many patients with these cutaneous lesions can be managed with "standard" therapies, including sunscreens, protective clothing and behavioral alteration, and topical corticosteroids with or without an oral antimalarial agent. These standard therapies are often not used appropriately, resulting in a situation in which the patient is felt to have refractory disease. This chapter discusses these therapies and defines what is meant by refractory disease and how the author approaches these patients.
Callen
Jeffrey P
JP
Division of Dermatology, School of Medicine, University of Louisville, 310 East Broadway, Louisville, KY 40202, USA. jefca@aol.com
D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D004333:Drug Administration Routes; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000175:diagnosis / Q000188:drug therapy*; D013473:Sunscreening Agents / Q000627:therapeutic use*; D016896:Treatment Outcome
D000962:Antimalarials; D005938:Glucocorticoids; D013473:Sunscreening Agents