Department of Dermatology, University of Münster, Münster, Germany.
Lupus. 2010 Aug;19(9):1125-36. doi: 10.1177/0961203310370345.
In patients with cutaneous lupus erythematosus (CLE) and mild skin involvement, local therapy consisting of topically applied pharmacological agents, e.g., topical/intralesional steroids, may be sufficient. Recent reports have also shown efficacy of topical calcineurin inhibitors in patients with CLE, particularly on the face. Special attention receives consistent sun protection through photoresistant clothing and application of light-shielding substances with highly potent chemical or physical UVA- and UVB-protective filters. These substances should be applied in sufficient amount (ca. 2 mg/cm(2)) at least 20-30 minutes before sun exposure in order to avoid induction and exacerbation of cutaneous lesions. The mainstay of treatment for disfiguring and widespread skin manifestations in patients with CLE, irrespective of the subtype of the disease, is antimalarial agents. Our understanding of the use of combinations of antimalarials and proper dosing according to the ideal bodyweight limits problems with toxicity. Further therapies, such as methotrexate, or retinoids, dapsone, mycophenolate mofetil, and thalidomide in selected cases, can be helpful for patients with resistant disease; however, side effects need to be taken into consideration. Recent advances in biotechnology resulted in the development of novel systemic agents, but randomized controlled trials are necessary for the approval of new therapeutic strategies in CLE.
在患有皮肤红斑狼疮(CLE)且皮肤受累较轻的患者中,局部治疗包括局部应用药物,例如局部/腔内类固醇,可能就足够了。最近的报告还显示,钙调神经磷酸酶抑制剂在 CLE 患者中,特别是在面部,具有疗效。特别需要通过耐光性衣物和具有高效化学或物理 UVA 和 UVB 保护滤光剂的遮光物质进行持续的防晒保护。这些物质应在暴露于阳光下之前至少 20-30 分钟以足够的量(约 2mg/cm(2))应用,以避免诱导和加重皮肤病变。无论疾病的亚型如何,对于患有 CLE 的患者来说,治疗影响美观和广泛皮肤表现的主要方法是抗疟药物。我们对抗疟药物联合使用和根据理想体重限制适当剂量的理解限制了毒性问题。对于耐药性疾病的患者,其他疗法,如甲氨蝶呤、类视黄醇、氨苯砜、霉酚酸酯和沙利度胺,在特定情况下可能会有所帮助;但是,需要考虑到副作用。生物技术的最新进展导致了新型系统药物的开发,但在批准 CLE 的新治疗策略方面,需要进行随机对照试验。