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Cutaneous lupus erythematosus: A review of the literature()

Knowledge with regard to the pathogenesis of lupus erythematosus has progressed rapidly over the past decade, and with it has come promising new agents for the treatment of cutaneous lupus erythematous (CLE). Classification of CLE is performed using clinical features and histopathologic findings, an...

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Autores principales: Blake, Stephanie Clare, Daniel, Benjamin Silas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938925/
https://www.ncbi.nlm.nih.gov/pubmed/31909151
http://dx.doi.org/10.1016/j.ijwd.2019.07.004
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author Blake, Stephanie Clare
Daniel, Benjamin Silas
author_facet Blake, Stephanie Clare
Daniel, Benjamin Silas
author_sort Blake, Stephanie Clare
collection PubMed
description Knowledge with regard to the pathogenesis of lupus erythematosus has progressed rapidly over the past decade, and with it has come promising new agents for the treatment of cutaneous lupus erythematous (CLE). Classification of CLE is performed using clinical features and histopathologic findings, and is crucial for determining prognosis and choosing therapeutic options. Preventative therapy is critical in achieving optimal disease control, and patients should be counseled on sun-safe behavior and smoking cessation. First-line therapy includes topical corticosteroids and calcineurin inhibitors, with antimalarial therapy. Traditionally, refractory disease was treated with oral retinoids, dapsone, and other oral immunosuppressive drugs, but new therapies are emerging with improved side effect profiles and efficacy. Biologic agents, such as belimumab and ustekinumab, have been promising in case studies but will require larger trials to establish their role in routine therapy. Other novel therapies that have been trialed successfully include spleen tyrosine kinase inhibitors and fumaric acid esters. Finally, new evidence has been published recently that describes safer dosing regimens in thalidomide and lenalidomide, both effective medications for CLE. Given the chronic disease course of CLE, long-term treatment-related side effects must be minimized, and the introduction of new steroid-sparing agents is encouraging in this regard.
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spelling pubmed-69389252020-01-06 Cutaneous lupus erythematosus: A review of the literature() Blake, Stephanie Clare Daniel, Benjamin Silas Int J Womens Dermatol Article Knowledge with regard to the pathogenesis of lupus erythematosus has progressed rapidly over the past decade, and with it has come promising new agents for the treatment of cutaneous lupus erythematous (CLE). Classification of CLE is performed using clinical features and histopathologic findings, and is crucial for determining prognosis and choosing therapeutic options. Preventative therapy is critical in achieving optimal disease control, and patients should be counseled on sun-safe behavior and smoking cessation. First-line therapy includes topical corticosteroids and calcineurin inhibitors, with antimalarial therapy. Traditionally, refractory disease was treated with oral retinoids, dapsone, and other oral immunosuppressive drugs, but new therapies are emerging with improved side effect profiles and efficacy. Biologic agents, such as belimumab and ustekinumab, have been promising in case studies but will require larger trials to establish their role in routine therapy. Other novel therapies that have been trialed successfully include spleen tyrosine kinase inhibitors and fumaric acid esters. Finally, new evidence has been published recently that describes safer dosing regimens in thalidomide and lenalidomide, both effective medications for CLE. Given the chronic disease course of CLE, long-term treatment-related side effects must be minimized, and the introduction of new steroid-sparing agents is encouraging in this regard. Elsevier 2019-07-31 /pmc/articles/PMC6938925/ /pubmed/31909151 http://dx.doi.org/10.1016/j.ijwd.2019.07.004 Text en © 2019 Published by Elsevier Inc. on behalf of Women's Dermatologic Society. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Blake, Stephanie Clare
Daniel, Benjamin Silas
Cutaneous lupus erythematosus: A review of the literature()
title Cutaneous lupus erythematosus: A review of the literature()
title_full Cutaneous lupus erythematosus: A review of the literature()
title_fullStr Cutaneous lupus erythematosus: A review of the literature()
title_full_unstemmed Cutaneous lupus erythematosus: A review of the literature()
title_short Cutaneous lupus erythematosus: A review of the literature()
title_sort cutaneous lupus erythematosus: a review of the literature()
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938925/
https://www.ncbi.nlm.nih.gov/pubmed/31909151
http://dx.doi.org/10.1016/j.ijwd.2019.07.004
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