title: Effectiveness of topical calcineurin inhibitors as monotherapy or in combination with hydroxychloroquine in cutaneous lupus erythematosus.
abstract: BACKGROUND
  Calcineurin inhibitors show potent anti-inflammatory effects and favorable safety profile when used in the treatment of cutaneous lupus erythematosus (CLE).
  
  
  OBJECTIVE
  The present study investigates the change in clinical parameters of erythema, desquamation and edema, when calcineurin inhibitors are used as monotherapy or in combination with hydroxychloroquine in CLE for a period of 60 days.
  
  
  METHODS
  18 patients were treated with topical tacrolimus and 20 patients with topical pimecrolimus, as monotherapy or in combination with hydroxychloroquine. Clinical parameters of erythema, desquamation and edema were assessed on a scale from 0 to 3 for erythema and edema and 0 to 2 for desquamation.
  
  
  RESULTS
  Statistically significant improvement in erythema, desquamation and edema was observed in patients on monotherapy with calcineurin inhibitor and combination treatment with hydroxychloroquine, regardless of disease type. Combination treatment resulted in improvement of edema in 100% of patients, while monotherapy did so in 75% of patients.
  
  
  CONCLUSIONS
  Topical calcineurin inhibitors enhance the therapeutic effect of systemic agents in cutaneous lupus erythematosus, and result in improvement of the clinical parameters studied.
authors.affiliation: First Department for Skin and Venereal Diseases, Andreas Syggros Hospital, National and Capodistrian University of Athens-Medical School, Athens, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Avgerinou
authors.forename: D-K
authors.initials: DK
authors.lastname: Papafragkaki
authors.forename: A
authors.initials: A
authors.lastname: Nasiopoulou
authors.forename: A
authors.initials: A
authors.lastname: Arapaki
authors.forename: A
authors.initials: A
authors.lastname: Katsambas
authors.forename: P G
authors.initials: PG
authors.lastname: Stavropoulos
mesh_terms: D000287:Administration, Topical; D000328:Adult; D065095:Calcineurin Inhibitors; D005260:Female; D006801:Humans; D006886:Hydroxychloroquine / Q000008:administration & dosage / Q000627:therapeutic use*; D008178:Lupus Erythematosus, Cutaneous / Q000188:drug therapy*; D008297:Male; D012189:Retrospective Studies
chemical_list: D065095:Calcineurin Inhibitors; D006886:Hydroxychloroquine