[Four cases of photopheresis treatment for cutaneous lupus erythematosus refractory to standard therapy].
BACKGROUND
Photopheresis is a leucopheresis procedure in which cells are photoactivated by psoralen and then irradiated by ultraviolet A. We report four cases of women with refractory cutaneous lupus erythematosus (LE) who responded to this treatment.


METHODS
We treated one patient with subacute LE having a contraindication to antimalarials and to thalidomide and three patients with chronic LE (lupus panniculitis, lupus tumidus and disseminated discoid LE) refractory to treatment with hydroxychloroquine, chloroquine, thalidomide and dapsone, and also, in some cases, to oral and intravenous corticosteroids, methotrexate, colchicine, acitretine, sulfasalazine, mycophenolate mofetil and intravenous immunoglobulin. Treatment consisted of two 4-hour sessions fortnightly. Only antimalarials were continued during photopheresis.


RESULTS
Photopheresis had a positive effect on all four patients. We noticed complete remission in two patients and interruption of progression followed by partial remission in the other two after a mean delay of two to three months of treatment. All treatments other than antimalarials were stopped.


CONCLUSIONS
Photopheresis appears to be an effective treatment option in patients with cutaneous LE. Due to its high cost, it should nevertheless remain an exceptional therapeutic option restricted to patients with cutaneous LE resistant to standard therapy.
Morruzzi
C
C
Clinique dermatologique, hôpital Civil, CHU de Strasbourg, 1, place de l'hôpital, 67000 Strasbourg, France.
Liu
V
V
Bohbot
A
A
Cribier
B
B
Lipsker
D
D
D000962:Antimalarials / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000188:drug therapy / Q000532:radiotherapy*; D008179:Lupus Erythematosus, Discoid / Q000188:drug therapy / Q000532:radiotherapy*; D017893:Photopheresis / Q000379:methods*; D016896:Treatment Outcome
D000962:Antimalarials