An update in drug-induced subacute cutaneous lupus erythematosus.
BACKGROUND
It has been over three decades sincethe first report of drug-induced subacute cutaneouslupus erythematosus (DI-SCLE) was described. Withan increasing variety of implicated drugs and thepotential for publication bias, we must consider: 1) hasthere been a change in drugs most often reported inDI-SCLE over time, and, 2) if so, of which drugs shouldclinicians be most suspicious in the setting of possibleDI-SCLE?


OBJECTIVE
To determine which drug(s) present thehighest risk for inducing DI-SCLE.


METHODS
The PubMed database was queried forreports of DI-SCLE from August, 2009 until May,2016. Cases reported in the English language wereorganized by drug class and compared with theresults of our previous review.


RESULTS
From 55 selected publications, 95 qualifiedreports of DI-SCLE were identified. With theexception of a population-based study from Sweden,all other reports of DI-SCLE appeared as case reportsor small case series. Cases associated with protonpump inhibitors relative to all other medicationswere increased by 34.1%. Reports associated withantihypertensive and antifungal medicationsdecreased by 28.9% and 22.4%, respectively duringthis timeframe. The majority of new reports wereassociated with drugs not previously described.Greater than 70% of reports since August, 2009 werefrom European countries.


CONCLUSIONS
The number of drugs associated withDI-SCLE is increasing. However, a form of publicationbias has likely contributed to this shift in reporting.There is a need for additional large, populationbasedstudies in this area.
Timothy C
TC
Michaelis
Department of Dermatology, University of Utah School of Medicine, Salt Lake City, Utah. richard.sontheimer@hsc.utah.edu.
Richard D
RD
Sontheimer
Garrett C
GC
Lowe
D000935:Antifungal Agents / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000009:adverse effects*; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects; D008178:Lupus Erythematosus, Cutaneous / Q000139:chemically induced*; D009281:Naphthalenes / Q000009:adverse effects; D054328:Proton Pump Inhibitors / Q000009:adverse effects*; D017594:Publication Bias; D000077291:Terbinafine
D000935:Antifungal Agents; D000959:Antihypertensive Agents; D009281:Naphthalenes; D054328:Proton Pump Inhibitors; D006852:Hydrochlorothiazide; D000077291:Terbinafine