An update on the management of refractory cutaneous lupus erythematosus

Alice Verdelli; Alberto Corrà; Elena Biancamaria Mariotti; Cristina Aimo; Valentina Ruffo di Calabria; Walter Volpi; Lavinia Quintarelli; Marzia Caproni

doi:10.3389/fmed.2022.941003

An update on the management of refractory cutaneous lupus erythematosus

Front Med (Lausanne). 2022 Sep 23:9:941003. doi: 10.3389/fmed.2022.941003. eCollection 2022.

Authors

Alice Verdelli¹, Alberto Corrà², Elena Biancamaria Mariotti², Cristina Aimo², Valentina Ruffo di Calabria², Walter Volpi¹, Lavinia Quintarelli³, Marzia Caproni³

Affiliations

¹ Section of Dermatology, Azienda USL Toscana Centro, Florence, Italy.
² Section of Dermatology, University of Florence, Florence, Italy.
³ Rare Dermatological Diseases Unit, Department of Health Sciences, Azienda USL Toscana Centro, University of Florence, Florence, Italy.

Abstract

Management of cutaneous lupus erythematosus (CLE) involves a combination of preventive measures, topical and systemic drugs, fairly similar for the different subtypes. Although guidelines exist, to date, no specific drugs have been specifically licensed for CLE. Antimalarials remain the first-line systemic treatment, but many patients do not respond, making refractory lupus a challenge for clinicians. The choice of alternative medication should be based on effectiveness, safety and cost. Most of the available drugs for CLE have been adapted from systemic lupus erythematosus (SLE) treatment but the existing literature is limited to small studies and evidence often lacks. As knowledge of pathogenesis of both CLE and SLE is improving, promising new therapies are emerging. In this review, we discuss the available medications, focusing on the novelties under development for CLE.

Keywords: JAK inhibitors; anifrolumab; belimumab; cutaneous lupus erythematosus (CLE); management; refractory; rituximab; therapy.

Publication types

Review