Chronic Cutaneous Lupus Erythematosus

What would you propose as therapeutic option in this

case?

Chronic cutaneous LE

63-year-old women. Diagnosed of Chronic Cutaneous

Lupus Erythematosus in 2006.

Chronic cutaneous LE

Physical examination• Smooth, non scarring, pink to

violaceous papules or plaques without evidence of surface change.

• Loceted on the face and upper extremities.

Chronic cutaneous LE

Skin Biopsy revealed:• A superficial and deep lymphocytic

infiltration in a perivascular and periadnexal distribution.

• Dermal interstitial mucin deposition and focal or absent dermoepidermal junction involvement.

Chronic cutaneous LE

Laboratory examinations: Antinuclear antibodies: 1/40.

Homogeneous. Anti SSA/RO: positive.

Chronic cutaneous LE

Chronic cutaneous LE

Chronic cutaneous LE

Treatment was prescribed without improvement in 2006:

Topical tacrolimus, pimecrolimus and corticosteroids.

Hydroxychloroquine at a dose of 400-600 mg/d for 6 months.

Prednisone at a dose of 0,5 mg/kg/d for 3 months.

Chronic cutaneous LE 2007

Chronic cutaneous LE 2007

Chronic cutaneous LE

Treatment was prescribed without improvement in 2007

Dapsone at a dose of 100 mg/d for 8 months.

Chronic cutaneous LE 2008

Chronic cutaneous LE

Treatment was prescribed without improvement in 2008-2009.

Methotrexate at a dose of 15mg at week for 4 months.

Chronic cutaneous LE 2009

What would you propose as therapeutic

option in this case?

Chronic cutaneous LE

F.Peral Rubio, M.D.

Department of Dermatology Complejo Hospitalario Universitario, Badajoz, Spain.