Callen Jeffrey P
Division of Dermatology, School of Medicine, University of Louisville, 310 East Broadway, Louisville, KY 40202, USA.
Best Pract Res Clin Rheumatol. 2005 Oct;19(5):767-84. doi: 10.1016/j.berh.2005.05.003.
Skin disease in patients with lupus erythematosus can be subdivided into two broad categories-those lesions that, when biopsied, demonstrate an interface dermatitis and those that do not demonstrate an interface dermatitis. The skin lesions that are represented by the interface dermatitis include discoid lupus erythematosus (DLE), subacute cutaneous lupus erythematosus (SCLE), and acute cutaneous lupus erythematosus. Many patients with these cutaneous lesions can be managed with "standard" therapies, including sunscreens, protective clothing and behavioral alteration, and topical corticosteroids with or without an oral antimalarial agent. These standard therapies are often not used appropriately, resulting in a situation in which the patient is felt to have refractory disease. This chapter discusses these therapies and defines what is meant by refractory disease and how the author approaches these patients.
一类病变经活检显示为界面性皮炎，另一类则未显示界面性皮炎。以界面性皮炎为特征的皮肤病变包括盘状红斑狼疮（DLE）、亚急性皮肤型红斑狼疮（SCLE）和急性皮肤型红斑狼疮。许多患有这些皮肤病变的患者可以采用“标准”疗法进行治疗，包括使用防晒霜、防护服、改变行为习惯，以及使用外用糖皮质激素，可联合或不联合口服抗疟药。这些标准疗法常常未得到恰当使用，导致患者被认为患有难治性疾病。本章将讨论这些疗法，并明确难治性疾病的含义以及作者对这些患者的治疗方法。
