Advancing understanding, diagnosis, and therapies for cutaneous lupus erythematosus within the broader context of systemic lupus erythematosus

Abstract

Cutaneous lupus erythematosus (CLE) is an autoimmune disease that can be associated with systemic lupus erythematosus (SLE) symptoms. The pathogenesis of both CLE and SLE is multifactorial, involving genetic susceptibility, environmental factors, and innate and adaptive immune responses. Despite the efficacy of current medications, many patients remain refractory, highlighting the necessity for new treatment options. Unfortunately, owing to challenges related in part to trial design and disease heterogeneity, only one new biologic in the last 50 years has been approved by the US Food and Drug Administration for the treatment of SLE. Thus, although SLE and CLE have a similar pathogenesis, patients with CLE who do not meet criteria for SLE cannot benefit from this advancement. This article discusses the recent trials and emphasizes the need to include patients with single-organ lupus, such as CLE, in SLE trials.

Selective Janus Kinase 1 Inhibition Is a Promising Therapeutic Approach for Lupus Erythematosus Skin Lesions

“…However, long term therapy with glucocorticosteroids is limited by side effects and, particularly in antimalarial-resistant patients, can be challenging. In addition still no specifically approved drugs exist and only a few clinical trials have been conducted, not least because of clinical heterogeneity and thus challenging trial design (16). Considering these limitations there is a strong unmet medical need for new therapeutic options.…”

SnapshotDx Quiz: January 2021

“…Topical therapy options include topical corticosteroids, commonly used despite limited evidence of effectiveness, or calcineurin inhibitors (Okon and Werth, 2013). Oral drugs such as hydroxychloroquine, systemic corticosteroids, immunosuppressant medications, biologics, or immunomodulators are often used to treat SLE or refractory CLE, although they have no specific Food and Drug Administration approval for the treatment of CLE (Chen et al, 2019). Acitretin is another oral option that may be effective in up to half of patients with CLE (Okon and Werth, 2013).…”

Lupus Erythematosus: Cutaneous Manifestations and Treatment

“…11 LE tumidus, initially included within the chronic subtype, is considered a separate form of cutaneous LE. 12,13 In a large study of more than thousand patients in Sweden, DLE was the most common subset (80%), followed by SCLE (15%), and less than 5% are other more rare types of CLE. 5 The LE-nonspecific manifestations are more frequently seen in patients with systemic disease and may also occur in other autoimmune diseases; they include vascular changes, exanthema, alopecia and mucous membrane lesions.…”