Lenalidomide for the Treatment of Resistant Discoid Lupus Erythematosus

Shah, Asha; Albrecht, Joerg; Bonilla-Martinez, Zuleika L.; Okawa, Joyce; Rose, Mathew; Rosenbach, Misha; Werth, Victoria P.

doi:10.1001/archdermatol.2009.30

Cited by 53 publications

(39 citation statements)

References 11 publications

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“…The CLASI has been shown to have good content validity, as well as inter-rater and intra-rater reliability. Since its development, the CLASI has been used in several studies that have examined all subsets of CLE 13, 22-27 .…”

Section: Methodsmentioning

confidence: 99%

Response to Antimalarial Agents in Cutaneous Lupus Erythematosus

Chang

Piette²,

Foering³

et al. 2011

Arch Dermatol

120

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Section: Methodsmentioning

confidence: 99%

Response to Antimalarial Agents in Cutaneous Lupus Erythematosus

Chang

Piette²,

Foering³

et al. 2011

Arch Dermatol

120

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“…More recently, lenalidomide, a structural derivative of thalidomide, has been shown to be a potential treatment for patients with refractory severe DLE, though larger studies are necessary [44]. There is some concern for increased activation of T cells with lenalidomide, which potentially could trigger SLE symptoms, although there does not appear to be as great a risk of peripheral neuropathy [5].…”

Section: Systemic Therapiesmentioning

confidence: 99%

Treatment of Cutaneous Lupus

Chang

Werth

2011

Curr Rheumatol Rep

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Cutaneous lupus erythematosus (CLE) is an autoimmune, inflammatory skin disease seen in patients with or without systemic lupus erythematosus (SLE). The management of CLE includes treatment and prevention of lesions, as well as routine assessment for systemic disease. Treatment options include both topical and systemic therapies. Topical therapies include corticosteroids and calcineurin inhibitors. Systemic therapies generally fall under one of three categories: antimalarials, immunomodulators, such as dapsone and thalidomide, and immunosuppressives, such as methotrexate and mycophenolate. Evidence for the treatment of CLE is limited by few prospective studies, as well as lack of a validated outcome measure up until recently. There is good evidence to support the use of topical steroids and calcineurin inhibitors, though most of these trials have not used placebo or vehicle controls. There have been no randomized placebo-controlled trials evaluating systemic therapies for the treatment of CLE.

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“…However, the recently developed and validated Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) provides a useful tool to facilitate future systematic research [53, 54]. Several recent studies using the CLASI have already provided valuable data to help optimize clinical therapy [55-59]. …”

Section: Overview Of Cutaneous Lupus Erythematosusmentioning

confidence: 99%

Cutaneous Lupus and the Cutaneous Lupus Erythematosus Disease Area and Severity Index Instrument

Klein

Morganroth

Werth

2010

Rheumatic Disease Clinics of North America

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This article provides an overview of cutaneous lupus erythematosus (CLE), including classification schemes, disease subtypes, and therapy. It also describes a novel clinical outcome instrument called the Cutaneous Lupus Erythematosus Disease Area and Severity Index, which quantifies cutaneous activity and damage in CLE. KeywordsCutaneous lupus erythematosus; disease classification; Rowell's syndrome; CLASI; clinical outcome instrument OVERVIEW OF CUTANEOUS LUPUS ERYTHEMATOSUS Disease ClassificationCutaneous LE skin lesions have been divided into two categories based on histopathology, LE-specific (histopathology shows interface dermatitis, which is specific for LE) and LEnonspecific (no interface dermatitis, histopathology is not specific for LE) [1,2]. The diagnosis of cutaneous LE can be confirmed by the presence of LE-specific lesions, whereas LE-nonspecific lesions may be seen in several diseases and thus are not sufficient for establishing a diagnosis of cutaneous LE. LE-specific skin lesions can be further subdivided based on clinical characteristics into acute cutaneous LE (ACLE), subacute cutaneous LE (SCLE), and chronic cutaneous LE (CCLE) [2]. Table 1 [ [2][3][4] summarizes the classification of skin lesions seen in LE patients.The risk of systemic LE (SLE) is highest in ACLE and lowest in CCLE, with SCLE falling in between. In one study of 191 patients with LE-specific skin lesions, the prevalence of underlying SLE was 72% in all patients with ACLE lesions, 58% in all patients with SCLE lesions, 28% in all patients with DLE lesions (the most common type of CCLE), and 6% in all patients with localized DLE lesions (limited to the head and neck) [5]. Notably, many patients from this study had lesions from more than one clinical category (ACLE, SCLE, or CCLE), and some had lesions from all three categories. In patients with DLE lesions but no ACLE or SCLE lesions, the underlying prevalence of SLE was 15%.Corresponding author for proof and reprints: Dr. Victoria P. Werth Department of Dermatology Perelman Center for Advanced Medicine, Suite 1-330A 3400 Civic Center Boulevard Philadelphia, PA 19104 Tel. 215-823-4208, Fax 866-755- Approximately 50% of SCLE patients fulfill the criteria for SLE [5], but SLE patients with SCLE appear to have fewer organ systems involved than SLE patients without SCLE. One study that compared inpatients with both SLE and SCLE to inpatients with only SLE found an increased prevalence of central nervous system disease, renal disease, arthritis, anemia, and pleuritis in the SLE-only group [24]. Another study that compared outpatients with SCLE (some also had SLE) to outpatients with SLE alone found an increased frequency of serositis (pleuritis or pericarditis) and hematologic abnormalities (hemolytic anemia, thrombocytopenia, or leukopenia) in the SLE-only group [25].Although drug-induced DLE is very rare, numerous drugs have been reported to induce SCLE. Drug-induced SCLE resembles idiopathic SCLE both clinically (papulosquamous or annular-polycyclic photodistributed les...

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Lenalidomide for the Treatment of Resistant Discoid Lupus Erythematosus

Cited by 53 publications

References 11 publications

Response to Antimalarial Agents in Cutaneous Lupus Erythematosus

Response to Antimalarial Agents in Cutaneous Lupus Erythematosus

Treatment of Cutaneous Lupus

Cutaneous Lupus and the Cutaneous Lupus Erythematosus Disease Area and Severity Index Instrument

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