Successful treatment of recalcitrant discoid lupus erythematosus with ustekinumab.
We report a 52-year old woman with a 28-year historyof disfiguring facial discoid lupus erythematosus(DLE), persistent despite both classical therapiesand rituximab. Ustekinumab 45 mg was started incombination with methotrexate and intralesionalcorticosteroids. Methotrexate and intralesionalcorticosteroids were withdrawn 30 months later andustekinumab maintained as monotherapy. Fortyeight months later stable improvement was achievedwithout side effects. Only nine patients with cutaneouslupus erythematosus (CLE) treated with ustekinumabhave been reported to date. Ustekinumab could be apromising alternative in severe and recalcitrant casesof CLE. Possibly, the Th17-inflammation pathway isplaying a role in these patients.
Department of Dermatology, Hospital Universitario de Fuenlabrada, Madrid. aromerom@salud.madrid.org.
Alberto
A
Romero-Maté
Carmen
C
García-Donoso
Almudena
A
Hernández-Núñez
Cristina
C
Martínez-Morán
Amalia
A
Moreno-Torres
Jesús
J
Borbujo-Martínez
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005148:Facial Dermatoses / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015552:Injections, Intralesional; D008179:Lupus Erythematosus, Discoid / Q000188:drug therapy* / Q000473:pathology; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D000069283:Rituximab / Q000627:therapeutic use; D017211:Treatment Failure; D000069549:Ustekinumab / Q000627:therapeutic use*
D000305:Adrenal Cortex Hormones; D003879:Dermatologic Agents; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab; D000069549:Ustekinumab; D008727:Methotrexate