title: Treatment of Scarring Alopecia in Discoid Variant of Chronic Cutaneous Lupus Erythematosus With Tacrolimus Lotion, 0.3.
abstract: OBJECTIVE
  Discoid lupus erythematosus (DLE) is a chronic variant of cutaneous lupus erythematosus, an autoimmune inflammatory disorder of the skin. Lesions are often localized to the scalp and can result in permanent scarring, disfiguration, and irreversible alopecia. Although DLE usually responds to topical or intralesional corticosteroids and/or oral antimalarials, some DLE is resistant to these treatments or adverse effects limit their effectiveness.
  
  
  METHODS
  Three patients with treatment-refractory, biopsy-proved DLE were prescribed a novel, off-label preparation of tacrolimus lotion, 0.3%, in an alcohol base as an adjunct to oral antimalarial therapy. All 3 patients demonstrated improvement in lesion severity and hair regrowth with the use of this regimen after 3 months and continued improvement thereafter. We report a retrospective analysis of these 3 cases.
  
  
  CONCLUSIONS
  This report is, to our knowledge, the first mention of tacrolimus being used in a lotion formulation to treat DLE lesions, resulting in hair regrowth. Topical tacrolimus lotion, 0.3%, in an alcohol base may be a potential therapeutic option for patients with DLE that is refractory to first-line therapies and who risk late-stage disease with permanent scarring alopecia.
authors.affiliation: Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Milam
authors.affiliation: Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.
authors.forename: Sarika
authors.initials: S
authors.lastname: Ramachandran
authors.affiliation: Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Franks
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000505:Alopecia / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D002921:Cicatrix / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D008179:Lupus Erythematosus, Discoid / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D012189:Retrospective Studies; D016559:Tacrolimus / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus