Drug-induced subacute cutaneous lupus erythematosus: evidence for differences from its idiopathic counterpart

Marzano, Angelo Valerio; Lazzari, Riccardo; Polloni, Ilaria; Crosti, C.; Fabbri, Paolo; Cugno, Massimo

doi:10.1111/j.1365-2133.2011.10397.x

Cited by 82 publications

(101 citation statements)

References 28 publications

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“…2 One study found that patients with drug-induced SCLE were older, had more extensive skin involvement and had an increased incidence of bullous, erythema multiforme-like and vasculitic lesions compared with individuals with idiopathic SCLE. 7 Photodistribution is characteristic as in our patient, and resolution occurred within a few months without treatment as noted in the literature. 8 Interestingly, our patient's unusual presentation of localised SCLE lesions on the hands may be explained by an occupational exposure to a topical drug, namely terbinafine.…”

Section: Discussionsupporting

confidence: 83%

Topical drug-induced subacute cutaneous lupus erythematosus isolated to the hands

et al. 2017

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Subacute cutaneous lupus erythematosus (SCLE) is a well-defined subtype of lupus erythematosus, characterised by photosensitivity, annular and/or psoriasiform lesions, variable systemic involvement and presence of circulating SSA/anti-Ro antibodies. SCLE may be idiopathic or drug-induced. Both the idiopathic and drug-induced forms of SCLE are analogous in their clinical, serological and histological features. Drug-induced SCLE has been reported with various oral agents, but to our knowledge this is the first reported case due to a topical medication. A 34-year-old female foot masseuse presented with a 2-month history of scaly, erythematous lesions isolated to the dorsal hands and interdigital spaces. She had used topical terbinafine, a topical antifungal cream, to her clients’ feet for a number of years. ANA and anti-SSA/Ro antibodies were positive. Physical examination, serology and histopathology were consistent with SCLE. We propose that our patient's unique presentation of SCLE may be explained by a prolonged occupational exposure to topical terbinafine as a foot masseuse. While oral terbinafine is a drug known to cause drug-induced SCLE, to our knowledge, this is the first topically induced form of the disease.

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Section: Discussionsupporting

confidence: 83%

Topical drug-induced subacute cutaneous lupus erythematosus isolated to the hands

et al. 2017

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“…However, Bonsmann et al [10 ]suggested that the involvement of the lower extremities might indeed indicate DI-SCLE, as in our case 1 and case 3. Marzano et al [11] reviewed 11 out of 90 cases of non-PPI DI-SCLE, and concluded that the histopathological and immunological characteristics of idiopathic and DI-SCLE are similar, but that DI-SCLE differs from idiopathic SCLE by virtue of distinctive clinical features, namely the widespread presentation and the frequent occurrence of bullous, targetoid and vasculitic manifestations distinctive in the drug-related variant of SCLE (not evident in our 3 cases).…”

Section: Discussionmentioning

confidence: 99%

Subacute Cutaneous Lupus Erythematosus Induced and Exacerbated by Proton Pump Inhibitors

Almebayadh

Régnier‐Rosencher²,

Carlotti³

et al. 2013

Dermatology

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Background: Subacute cutaneous lupus erythematosus (SCLE) can be induced by numerous drugs. We report 3 cases of SCLE induced by proton pump inhibitors (PPIs). Objective: To highlight a rare cutaneous side effect induced by a frequently prescribed drug such as a PPI. Case Reports: Case 1 was a 30-year-old man who developed multiple annular plaques over the trunk and lower limbs 1 month after the initiation of pantoprazole. Antinuclear antibodies (ANA) were positive with anti-Ro/SSA and anti-La/SSB antibodies, and histology confirmed the diagnosis. Clinical improvement was achieved 8 weeks after the discontinuation of pantoprazole and the introduction of a treatment combining topical steroids and hydroxychloroquine. Lesions relapsed when pantoprazole was accidentally rechallenged. The second case was a 31-year-old woman, 28 weeks pregnant, who presented erythematous annular plaques over the trunk 7 weeks after starting esomeprazole. ANA and anti-Ro/SSA antibodies were positive, and the histology was compatible with SCLE. Fetal ultrasound was normal. She was treated with topical and oral steroids and hydroxychloroquine. Clinical improvement was achieved 4 weeks after the discontinuation of esomeprazole. The third case was a 57-year-old woman with systemic erythematosus lupus presenting annular and psoriasiform lesions on the trunk for 15 months. She was treated successively with hydroxychloroquine, azathioprine, mycophenolate mofetil and methotrexate with prednisone. A review of her drug history revealed the introduction of omeprazole a few weeks before the first appearance of skin lesions and omeprazole was contraindicated. Conclusion: SCLE should systematically be suspected in case of eruption after the introduction of PPI. The risk of fetal cardiac complications is important in pregnant women.

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“…Another big challenge is to differentiate drug-induced SCLE from idiopathic SCLE. Marzano et al [11] reported that drug induced-SCLE differs from idiopathic SCLE by virtue of distinctive cutaneous features, particularly the widespread presentation and the frequent occurrence of malar rash and bullous, EM-like, and vasculitic manifestations.…”

Section: Clinical Featuresmentioning

confidence: 98%

Update on cutaneous lupus erythematosus

Chandrashekar

2012

Indian J Dermatol Venereol Leprol

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Drug-induced subacute cutaneous lupus erythematosus: evidence for differences from its idiopathic counterpart

Abstract: DI-SCLE differs from idiopathic SCLE by virtue of distinctive cutaneous features, particularly the widespread presentation and the frequent occurrence of malar rash and bullous, EM-like and vasculitic manifestations.

Cited by 82 publications

References 28 publications

Topical drug-induced subacute cutaneous lupus erythematosus isolated to the hands

Topical drug-induced subacute cutaneous lupus erythematosus isolated to the hands

Subacute Cutaneous Lupus Erythematosus Induced and Exacerbated by Proton Pump Inhibitors

Update on cutaneous lupus erythematosus

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