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皮肤红斑狼疮:进展与挑战。

Cutaneous Lupus Erythematosus: Progress and Challenges.

机构信息

School of Medicine, Duke University, Durham, NC, 27710, USA.

Department of Dermatology, Duke University, Durham, NC, 27710, USA.

出版信息

Curr Allergy Asthma Rep. 2020 Apr 4;20(5):12. doi: 10.1007/s11882-020-00906-8.

Abstract

PURPOSE OF REVIEW

The review provides an update on the diagnosis, pathogenesis, and treatment of cutaneous lupus erythematosus (CLE).

RECENT FINDINGS

Diagnostic challenges exist in better defining CLE as an independent disease distinct from systemic lupus erythematosus with cutaneous features and further classifying CLE based on clinical, histological, and laboratory features. Recent mechanistic studies revealed more genetic variations, environmental triggers, and immunologic dysfunctions that are associated with CLE. Drug induction specifically has emerged as one of the most important triggers for CLE. Treatment options include topical agents and systemic therapies, including newer biologics such as belimumab, rituximab, ustekinumab, anifrolumab, and BIIB059 that have shown good clinical efficacy in trials. CLE is a group of complex and heterogenous diseases. Future studies are warranted to better define CLE within the spectrum of lupus erythematosus. Better insight into the pathogenesis of CLE could facilitate the design of more targeted therapies.

摘要

目的综述

本文就皮肤红斑狼疮(CLE)的诊断、发病机制和治疗提供了最新信息。

最近的发现

目前存在诊断方面的挑战,即更好地定义 CLE 是一种独立的疾病,与具有皮肤表现的系统性红斑狼疮不同,并根据临床、组织学和实验室特征进一步对 CLE 进行分类。最近的机制研究揭示了更多与 CLE 相关的遗传变异、环境触发因素和免疫功能障碍。药物诱导特别是 CLE 的一个最重要的触发因素。治疗选择包括局部制剂和全身治疗,包括新型生物制剂,如贝利木单抗、利妥昔单抗、乌司奴单抗、阿尼鲁单抗和 BIIB059,这些药物在临床试验中显示出良好的临床疗效。CLE 是一组复杂且异质的疾病。未来的研究有必要在红斑狼疮的范围内更好地定义 CLE。深入了解 CLE 的发病机制可以促进更有针对性的治疗方法的设计。

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