title: Leflunomide in subacute cutaneous lupus erythematosus - two sides of a coin.
abstract: BACKGROUND
  Subacute cutaneous lupus erythematosus (SCLE), a distinct clinical subset of lupus erythematosus, remains a therapeutic challenge, especially in cases resistant to topical and standard systemic therapy. Leflunomide, a novel antirheumatic drug, has shown efficacy in the treatment of systemic lupus erythematosus in pilot studies.
  
  
  METHODS
  We report two patients with SCLE who demonstrated the spectrum of possible clinical responses to leflunomide therapy.
  
  
  RESULTS
  One patient experienced a complete clinical remission of symptoms, whereas the other developed a massive skin reaction which was distinctly related to the commencement of leflunomide therapy.
  
  
  CONCLUSIONS
  To our knowledge, this is the first time that remission and deterioration of SCLE by leflunomide therapy have been described.
authors.affiliation: Department of Dermatology, University of Leipzig, Leipzig, Germany. anke.suess@medizin.uni-leipzig.de
authors.forename: Anke
authors.initials: A
authors.lastname: Suess
authors.forename: Michael
authors.initials: M
authors.lastname: Sticherling
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D003937:Diagnosis, Differential; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology*; D004791:Enzyme Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D004892:Erythema Multiforme / Q000139:chemically induced* / Q000175:diagnosis; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007555:Isoxazoles / Q000008:administration & dosage* / Q000009:adverse effects; D000077339:Leflunomide; D008178:Lupus Erythematosus, Cutaneous / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D012867:Skin / Q000473:pathology
chemical_list: D018501:Antirheumatic Agents; D004791:Enzyme Inhibitors; D007555:Isoxazoles; D000077339:Leflunomide