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2013 ; 25
(5
): 584-90
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Update on pathogenesis and treatment of CLE
#MMPMID23872903
Privette ED
; Werth VP
Curr Opin Rheumatol
2013[Sep]; 25
(5
): 584-90
PMID23872903
show ga
PURPOSE OF REVIEW: Cutaneous Lupus Erythematous (CLE) is an autoimmune disease in
which patients may present with isolated skin findings or have CLE associated
with underlying systemic disease. The most significant recent studies on its
pathogenesis and therapeutic management are reviewed here. RECENT FINDINGS:
Patients with subacute and Discoid Lupus Erythematous had elevated Interferon
score, about a third of all cases of SCLE could be attributed to previous drug
exposure, and smoking may be more closely associated with CLE than Systemic Lupus
Erythematous (SLE). An underlying genetic defect in some subsets of CLE patients
may also be shared with SLE. Efficacy of antimalarial therapy is enhanced by
increasing treatment duration or maintaining higher blood drug concentrations.
Combination antimalarials that include quinacrine, thalidomide analogs, and
Mycophenalate Mofetil may also be effective in refractory CLE. SUMMARY: The
pathogenesis of CLE remains unclear, and is likely multifactorial. Identified
associations with subsets of CLE suggest future research questions in CLE
pathogenesis. Subsets of CLE associated with interface dermatitis may share an
underlying genetic defect in interferon signaling with SLE. The Cutaneous Lupus
Disease Area and Severity Index is a valuable and widely used tool allowing
standardized assessment and reporting of cutaneous disease activity and damage.
More evidence is available to guide treatment of refractory CLE, but larger
studies are needed. VIDEO ABSTRACT: http://links.lww.com/COR/A4.