title: Advances in the treatment of cutaneous lupus erythematosus.
abstract: Lupus erythematosus (LE) is a multifactorial autoimmune disease with clinical manifestations of differing severity which may present with skin manifestations as primary sign of the disease (cutaneous lupus erythematosus, CLE) or as part of a disease spectrum (systemic lupus erythematosus, SLE). To date, no drugs are approved specifically for the treatment of CLE and only single agents have been applied in randomized controlled trials. Therefore, topical and systemic agents are used "off-label", primarily based on open-label studies, case series, retrospective analyses, and expert opinions. In contrast, several agents, such as hydroxychloroquine, chloroquine, cyclophosphamide, azathioprine, and belimumab, are approved for the treatment of SLE. Recent approaches in the understanding of the molecular pathogenesis of LE enabled the development of further new agents, which target molecules such as interleukin 6 (IL-6) and interferon (IFN). Only single trials, however, applied these new agents in patients with cutaneous involvement of the disease and/or included endpoints which evaluated the efficacy of these agents on skin manifestations. This article provides an updated review on new and recent approaches in the treatment of CLE.
authors.affiliation: Interdisciplinary Center for Clinical Trials (IZKS), University Medical Center Mainz, Germany Division of Immunogenetics, Tumor Immunology Program, German Cancer Research Center, Heidelberg, Germany research@izks-unimedizin-mainz.de.
authors.forename: A
authors.initials: A
authors.lastname: Kuhn
authors.affiliation: Division of Immunogenetics, Tumor Immunology Program, German Cancer Research Center, Heidelberg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Landmann
authors.affiliation: Department of Dermatology, University of Bonn, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Wenzel
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000906:Antibodies / Q000627:therapeutic use; D001402:B-Lymphocytes / Q000187:drug effects; D015415:Biomarkers / Q000097:blood; D000068800:Etanercept / Q000627:therapeutic use; D006801:Humans; D007372:Interferons / Q000037:antagonists & inhibitors; D008179:Lupus Erythematosus, Discoid / Q000175:diagnosis* / Q000188:drug therapy*; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D058990:Molecular Targeted Therapy; D011092:Polyethylene Glycols / Q000627:therapeutic use; D057285:Precision Medicine; D016032:Randomized Controlled Trials as Topic; D015398:Signal Transduction / Q000187:drug effects*; D000093242:Interleukin-6 Inhibitors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000906:Antibodies; D015415:Biomarkers; D000068800:Etanercept; D007372:Interferons; D011092:Polyethylene Glycols; D000093242:Interleukin-6 Inhibitors; C000604694:lulizumab pegol
keywords: Cutaneous lupus erythematosus; discoid lupus erythematosus; subacute lupus erythematosus; systemic lupus erythematosus