RT Journal Article
SR Electronic
T1 13 Management of lupus skin manifestations
JF Lupus Science & Medicine
JO Lupus Sci Med
FD Lupus Foundation of America
SP A7
OP A7
DO 10.1136/lupus-2022-la.13
VO 9
IS Suppl 1
A1 Caproni, Marzia
YR 2022
UL http://lupus.bmj.com/content/9/Suppl_1/A7.1.abstract
AB Case 1. A 75-year-old woman with erythematous-scaling plaque of the noseA 75-year-old woman presented with a unique erythematous-scaling plaque of the nose. A skin biopsy showed an interface dermatitis, consistent with the diagnosis of localised cutaneous lupus. Based on clinical and laboratory findings, systemic lupus was revealed. According to guidelines, hydroxychloroquine 400 mg/day was introduced in association with topical treatment with resolution of skin lesions in a few weeks with no relapses in the follow-up period. Case 2. Recalcitrant skin lesion in a 62-year-old woman with systemic lupus erythematosusA 62-year-old-woman with a 16 year-history of systemic lupus, presented with erythematous-infiltrated and partially hyperkeratotic skin lesions on the trunk, arms and face. Lesions were extremely itchy. A skin biopsy confirmed cutaneous lupus. All systemic treatments, including hydroxychloroquine, quinacrine and belimumab failed. The patient was re-evaluated to exclude the presence of external factors associated to the exacerbation of the disease. Finally, methotrexate 15 mg weekly improved the lesions. Discussion Points: We discuss two cases focusing on the importance of correct diagnosis and treatment of specific lupus skin lesions. Antimalarials remain the first-line therapeutic option, but choice of other drugs should be taken into consideration in cases of refractory forms of cutaneous lupus.Learning ObjectivesDiscuss the therapeutic guidelines of lupus erythematosusDiscuss the therapeutic options in recalcitrant cutaneous lupus erythematosusExplain the role of itching in cutaneous lupus erythematosusDescribe factors predicting exacerbation