[Systemic treatment of cutaneous lupus erythematosus].
The treatment of cutaneous lupus erythematosus (CLE) remains a therapeutic challenge. In many cases, systemic treatment of the disease is necessary, especially in cases resistant to topical treatment or with internal organ involvement. Even though many different agents can be employed in this situation, most are not approved in Germany for the treatment of CLE. We give an overview of the agents used in the systemic treatment of CLE and review their mechanisms of action, indications and their practical use in cutaneous LE based on literature results and our own experience. We discuss corticosteroids, antimalarials, dapsone, azathioprine, cyclophosphamide, methotrexate, retinoids, cyclosporine A, mycophenolate mofetil, sulfasalazine, thalidomide, clofazimine, tacrolimus, immunoglobulins, monoclonal antibodies, plasmapheresis, etanercept, infliximab, feflunomid, gold and interferon-alpha.
Wenzel
Joerg
J
Klinik und Poliklinik für Dermatologie, Universitätsklinikum Bonn. joerg.wenzel@ukb.uni-bonn.de
Bieber
Thomas
T
Uerlich
Manfred
M
Tüting
Thomas
T
D000208:Acute Disease; D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use; D001379:Azathioprine / Q000008:administration & dosage / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D003622:Dapsone / Q000008:administration & dosage / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D006046:Gold / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use; D008178:Lupus Erythematosus, Cutaneous / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000627:therapeutic use; D010956:Plasmapheresis; D011247:Pregnancy; D012176:Retinoids / Q000008:administration & dosage / Q000627:therapeutic use; D013792:Thalidomide / Q000008:administration & dosage / Q000627:therapeutic use; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D000962:Antimalarials; D003879:Dermatologic Agents; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D016898:Interferon-alpha; D012176:Retinoids; D013792:Thalidomide; D006046:Gold; D003520:Cyclophosphamide; D003622:Dapsone; D001379:Azathioprine; D008727:Methotrexate