Rituximab in the treatment of extensive and refractory subacute cutaneous lupus erythematosus

Penha, Mariana Álvares; Libório, Ricardo da Silva; Miot, Hélio Amante

doi:10.1590/abd1806-4841.20187561

Cited by 10 publications

(13 citation statements)

References 6 publications

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“…Rituximab is an anti-CD20 monoclonal antibody approved for the treatment of non-Hodgkin lymphoma, chronic lymphocytic leukemia, and rheumatoid arthritis, but it is used off-label for many other conditions [ 11 ]. Studies have shown its effectiveness in treating autoimmune skin disorders, such as pemphigus vulgaris, pemphigus foliaceus, vasculitis, SLE, and SCLE [ 12 ]. Currently, there are seventeen cases of cutaneous manifestation of SLE and eight cases with refractory SCLE treated with rituximab [ 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown its effectiveness in treating autoimmune skin disorders, such as pemphigus vulgaris, pemphigus foliaceus, vasculitis, SLE, and SCLE [ 12 ]. Currently, there are seventeen cases of cutaneous manifestation of SLE and eight cases with refractory SCLE treated with rituximab [ 12 , 13 ]. Of the eight refractory SCLE cases, seven showed effective results except one.…”

Section: Discussionmentioning

confidence: 99%

“…Of the eight refractory SCLE cases, seven showed effective results except one. The dosing regimen was varied from 1 g every 2 weeks to 375 mg/m 2 weekly for 4 weeks [ 12 ]. Maintenance doses varied from every 2 months to 1 year.…”

Section: Discussionmentioning

confidence: 99%

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Utilization of Rituximab for Refractory Rowell Syndrome

Singh

Sheffield

Chowdhury

et al. 2021

Case Reports in Rheumatology

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Rowell syndrome describes the occurrence of erythema multiforme-like lesions in patients with cutaneous lesions of lupus erythematosus. The clinical picture of atypical erythema multiforme-like lesions, presence of chilblains, speckled ANA pattern, anti-Ro/SSA, or anti-La/SSB antibodies, and absence of infectious or pharmacologic triggers in a patient with systemic lupus erythematosus are some of the classic clinical and serologic features. Histopathologic and serologic findings can help differentiate this process from erythema multiforme. We present a case of young woman with systemic lupus erythematosus, end-stage renal disease due to lupus nephritis, and a remote history of Steven–Johnson syndrome due to sulfa allergy who presented to the hospital with a recurrent, progressive, targetoid erythematous rash involving more than 60% of her body surface area. Our patient had several hospitalizations in the recent past for this erythematous rash and had failed oral therapy with prednisone 1 mg/kg and hydroxychloroquine. In view of the minimal improvement and increasing severity and patient exhibiting early features of mast cell activation syndrome, the patient was treated with pulse intravenous glucocorticoids followed by rituximab with an excellent response. We highlight a unique case report of progressive Rowell syndrome refractory to standard of care with an excellent response to rituximab.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Utilization of Rituximab for Refractory Rowell Syndrome

Singh

Sheffield

Chowdhury

et al. 2021

Case Reports in Rheumatology

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“…Aunque la fotoprotección, el tratamiento tópico y sistémico con corticoides y antipalúdicos se consideran un tratamiento de primera línea, un 50% de los pacientes se comportan de forma refractaria 10,11 . En estos pacientes las drogas inmunosupresoras, como azatioprina, metotrexato, micofenolato de mofetilo y ciclosporina, pueden constituir un tratamiento de segunda línea.…”

Section: Discussionunclassified

Rituximab en lupus sistémico ampolloso

Cruz

Graña-Cruz

Pérez

et al. 2020

Rev Esp Casos Clin Med Intern

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“…"High-dose" IVIG (2 g/kg BW/month) has been used successfully in autoimmune diseases. Several case reports and case series have shown positive effects in refractory CLE [87][88][89], but deterioration of skin lesions in SCLE and SLE has also been observed. One study treated 16 treatment-refractory patients with IVIG 500 mg/kg BW/day on four consecutive days up to a total of 2 g/kg BW/month over a period of three months.…”

Section: Intravenous Immunglobulinsmentioning

confidence: 99%

S2k guideline: Diagnosis and management of cutaneous lupus erythematosus – Part 2: Therapy, risk factors and other special topics

Worm

Zidane

Eisert³

et al. 2021

J Deutsche Derma Gesell

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Topical treatment Topical glucocorticoidsClass 2-4 topical glucocorticoids are the treatment of choice for cutaneous lupus erythematosus (CLE). A randomized, controlled study has shown that fluocinonide 0.05 % is more effective than hydrocortisone 1 % [1]. Class 4 topical glucocorticoids are indicated for lesions on the capillitium, the palms of the hands/soles of the feet, and for hyperkeratotic lesions, covered by a foil/hydrocolloid dressing where required. Strictly intralesional injections of triamcinolone acetonide may be considered in individual cases, and this may be repeated after 4-6 weeks as needed. Side effects with use over longer periods of time are a limiting factor, so either short-term use over a period of several weeks, or interval treatment is recommended. Recommendation Strength AgreementTopical glucocorticoids are recommended for treating circumscribed CLE lesions.

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Rituximab in the treatment of extensive and refractory subacute cutaneous lupus erythematosus

Cited by 10 publications

References 6 publications

Utilization of Rituximab for Refractory Rowell Syndrome

Utilization of Rituximab for Refractory Rowell Syndrome

Rituximab en lupus sistémico ampolloso

S2k guideline: Diagnosis and management of cutaneous lupus erythematosus – Part 2: Therapy, risk factors and other special topics

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