title: Treatment of cutaneous lupus erythematosus: current practice variations.
abstract: The treatment of cutaneous lupus erythematous (CLE) remains a challenge. Most of the therapeutic options used in CLE have not been tested in randomized controlled studies and to date no agent has been approved. Therefore, CLE treatment is mostly based on personal experience. To better characterize therapeutic habits among physicians treating CLE patients, a questionnaire-based study about various aspects of topical and systemic treatment for CLE has been performed. The questionnaire was distributed among CLE experts, mostly from Japan, the USA, and Europe. A total of 82 completed questionnaires were assessed. High-potent and potent corticosteroids as well as calcineurin inhibitors were the most often recommended topical treatment for all CLE subtypes. The most relevant factors for initiation of systemic therapy were severity of skin lesions, concomitant involvement of internal organs, CLE subtype and lack of response to topical therapies. Corticosteroids and antimalarials were considered as the most suitable and effective systemic drugs for CLE patients. However, significant differences were observed between various CLE subtypes and between different countries regarding the assessment of various topical and systemic treatment options. In conclusion, great variability of obtained answers underlines the need of development of CLE treatment guidelines suitable for different disease subtypes.
authors.affiliation: Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland adam.reich@umed.wroc.pl.
authors.forename: A
authors.initials: A
authors.lastname: Reich
authors.affiliation: Philadelphia Veterans Affairs Medical Center and Department of Dermatology University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
authors.forename: V P
authors.initials: VP
authors.lastname: Werth
authors.affiliation: Department of Dermatology, Wakayama Medical University, Wakayama, Japan.
authors.forename: F
authors.initials: F
authors.lastname: Furukawa
authors.affiliation: Interdisciplinary Center for Clinical Trials, University Medical Center, Mainz, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Kuhn
authors.affiliation: Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Szczęch
authors.affiliation: Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: D
authors.initials: D
authors.lastname: Samotij
authors.affiliation: Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: J C
authors.initials: JC
authors.lastname: Szepietowski
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000627:therapeutic use*; D065095:Calcineurin Inhibitors / Q000627:therapeutic use*; D005060:Europe; D006801:Humans; D007564:Japan; D008178:Lupus Erythematosus, Cutaneous / Q000188:drug therapy* / Q000473:pathology*; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States
chemical_list: D000305:Adrenal Cortex Hormones; D000962:Antimalarials; D065095:Calcineurin Inhibitors
keywords: CCLE; CLE; DLE; ICLE; LET; SCLE; therapy