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IntroductionThere are no drugs specifically approved to treat cutaneous lupus. Inflammatory cells in lupus skin lesions can produce leukotrienes (LT), which promote tissue damage. In addition to hypersensitivity reactions, LT are also associated with cardiovascular diseases and elevated serum LT levels have been linked to worse atherosclerotic disease in lupus. Targeting LT could thus be an alternative to treat lupus. We present 4 cases of cutaneous lupus successfully treated with montelukast (MLK), a Cys‐LT antagonist.MethodsFour consecutive female systemic lupus erythematosus (SLE) patients with refractory skin lesions were treated with MLK (10 mg/d) in the Hospital Universitário Walter Cantídio of the Universidade Federal do Ceará. Skin lesions were scored using Revised Cutaneous LE Disease Area and Severity Index (RCLASI). Relative expression of the 5‐lipoxigenase (ALOX5) and 15‐lipoxigenase (ALOX15) genes was determined in peripheral blood cells (PBC) from lupus patients and 4 age‐matched female controls.ResultsAll patients experienced improvement of skin lesions measured using RCLASI scores within 2–12 weeks following initiation of MLK. The response was sustained for at least 3 months follow‐up and no adverse events were recorded. ALOX5 but not ALOX15 gene expression was significantly (P = 0.0425) increased in PBC from SLE patients vs controls.ConclusionThis is the first report of a fast and sustained successful response of cutaneous lupus to MLK. Given its acceptable safety profile, our data encourage development of a randomized trial as an attempt to reposition MLK as a safe, affordable alternative to treat cutaneous lupus.

BackgroundInflammatory back pain (IBP) is a major criterion in identifying axial spondyloarthritis. Whether socioeconomic issues impact prevalence of IBP assessed using standardized questionnaires has not been assessed. We determined IBP prevalence and performance of IBP questionnaires in a low-income, low-literacy population.MethodsIndividuals were interviewed in Fortaleza, Brazil, for the prevalence of IBP using Calin's, Berlin, and ASAS IBP questionnaires; monthly family income (US dollars), literacy (>/≤8 school years [SYs]), and smoking habit (present/absent) were registered.ResultsTwo hundred nineteen individuals were included (mean age, 38.2 ± 12.9 years), 110 (50.2%) men, 58 (26.4%) White, and 38 (17.3%) smokers. Overall, 152 (69.4%) declared

BACKGROUND Juvenile Idiophatic Arthritis (JIA) is the most prevalent cause of chronic arthritis in childhood. Both genetic and environmental factors influence JIA incidence and outcomes. Our aim was to evaluate the relation between tobacco exposure and JIA. MATERIALS AND METHODS Data from 89 JIA outpatients followed in two public hospitals from Fortaleza-CE were compared to that from 85 controls. Chi-square was used to compare maternal and familiar smoking between patients and controls. Any child with a smoking family member (including mother) living in the same household was categorized as familiar smoking. Protocol was approved by the local ethics committee (CAAE-72914316.4.3001.5045). RESULTS Among JIA patients, 17% were exposed to maternal smoking and 38% to familiar smoking, whereas among healthy controls these numbers were 8.2 and 17% respectively. JIA patients had a tendency to higher maternal smoking prevalence (p=0.082) and showed statistically significant higher prevalence of familiar smoking (p=0.002).

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