title: Drug-induced cutaneous lupus erythematosus: 88 new cases.
abstract: BACKGROUND
  An increasing number of drugs have been linked to drug-induced subacute cutaneous lupus erythematosus (DI-SCLE). The recognition and management of DI-SCLE can be challenging, as the condition may be triggered by different classes of drugs after variable lengths of time.
  
  
  OBJECTIVE
  To determine the proportion of patients with cutaneous lupus erythematosus (CLE) whose drugs are an inducing or aggravating factor.
  
  
  METHODS
  We conducted a retrospective chart review of patients diagnosed with CLE at a dermatological department over a 21-year period. We registered clinical, serological, and histological data with a focus on drug intake.
  
  
  RESULTS
  Of 775 consecutive patients with a diagnosis of lupus erythematosus (LE) or suspected LE, a diagnosis of CLE could be confirmed in 448 patients. A total of 130 patients had a drug intake that could suggest DI-SCLE. In 88 cases, a drug was evaluated to be definitely, probably, or possibly triggering CLE using the Naranjo probability scale. The most common drugs involved were proton pump inhibitors (PPIs), thiazide diuretics, antifungals, chemotherapeutics, statins, and antiepileptics. The incubation period varied widely with a median of eight weeks. The characteristics of DI-SCLE patients were more widespread rash relative to the other patients, with inflamed skin lesions or atypical variants which could resemble erythema multiforme.
  
  
  CONCLUSIONS
  We present 88 patients with DI-SCLE, which is the largest case series reported, to date. DI-SCLE represented 20% of patients with CLE seen at our department. We conclude that DI-SCLE should be considered in every case of SCLE.
authors: Department of Dermatology and Allergy Centre, Odense University Hospital, DK-5000, Odense C, Denmark.
authors: Rasa
authors: R
authors: Laurinaviciene
authors: Department of Dermatology and Allergy Centre, Odense University Hospital, DK-5000, Odense C, Denmark.
authors: Linda Holm
authors: LH
authors: Sandholdt
authors: Department of Dermatology and Allergy Centre, Odense University Hospital, DK-5000, Odense C, Denmark.
authors: Anette
authors: A
authors: Bygum
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000009:adverse effects; D000935:Antifungal Agents / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects; D018450:Disease Progression; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects; D008178:Lupus Erythematosus, Cutaneous / Q000139:chemically induced* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D012189:Retrospective Studies; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects*; D013997:Time Factors
chemical_list: D000927:Anticonvulsants; D000935:Antifungal Agents; D000970:Antineoplastic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D054328:Proton Pump Inhibitors; D049993:Sodium Chloride Symporter Inhibitors
keywords: cutaneous lupus erythematosus; drug reactions; drug-induced cutaneous lupus erythematosus