Aljohani Roaa
Department of Medicine, College of Medicine, Taibah University, Medina, Saudi Arabia.
Department of Medicine, King Faisal Specialist Hospital and Research Centre, Medina, Saudi Arabia.
Medicine (Baltimore). 2025 May 16;104(20):e42518. doi: 10.1097/MD.0000000000042518.
Discoid lupus erythematosus (DLE) is a chronic, refractory condition causing visible scarring and significant psychological distress. Standard treatments often fail to provide adequate relief, necessitating new therapeutic options.
A 43-year-old woman with longstanding DLE experienced recurrent scalp lesions unresponsive to multiple therapies, including high-dose corticosteroids, which caused adverse effects. A 19-year-old woman with systemic lupus erythematosus presented with persistent discoid scalp lesions, disfigurement, and emotional distress despite standard treatments.
Both patients were diagnosed with refractory DLE, confirmed by clinical findings and skin biopsies.
Both patients received monthly intravenous anifrolumab (300 mg) alongside hydroxychloroquine and methotrexate. Significant improvement was noted after the first dose, including reduced lesion severity, erythema, and itchiness, with visible hair regrowth. The first patient Cutaneous Lupus Erythematosus Disease Area and Severity Index-Activity score improved from 18 to 3, allowing complete corticosteroid discontinuation. The second patient Cutaneous Lupus Erythematosus Disease Area and Severity Index-Activity score decreased from 8 to 1. No adverse effects were reported.
These cases demonstrate anifrolumab potential as a treatment for refractory DLE, offering rapid and sustained improvement in disease severity and quality of life while reducing corticosteroid dependency. These findings suggest anifrolumab as a viable alternative for challenging DLE cases, warranting further research to confirm its efficacy and safety in larger populations.
盘状红斑狼疮（DLE）是一种慢性难治性疾病，会导致明显的瘢痕形成和严重的心理困扰。标准治疗往往无法提供充分缓解，因此需要新的治疗选择。
一名患有长期DLE的43岁女性经历了复发性头皮病变，对包括高剂量皮质类固醇在内的多种治疗均无反应，而高剂量皮质类固醇还引起了不良反应。一名患有系统性红斑狼疮的19岁女性尽管接受了标准治疗，但仍出现持续性盘状头皮病变、毁容和情绪困扰。
两名患者均被诊断为难治性DLE，通过临床检查和皮肤活检得以确诊。
两名患者均接受每月一次的静脉注射阿尼鲁单抗（300毫克），同时服用羟氯喹和甲氨蝶呤。首剂后即观察到显著改善，包括病变严重程度减轻、红斑和瘙痒减轻，并有明显的头发生长。第一名患者的皮肤红斑狼疮疾病面积和严重程度指数-活动评分从18分降至3分，从而能够完全停用皮质类固醇。第二名患者的皮肤红斑狼疮疾病面积和严重程度指数-活动评分从8分降至1分。未报告不良反应。
这些病例证明了阿尼鲁单抗治疗难治性DLE的潜力，可快速且持续地改善疾病严重程度和生活质量，同时减少对皮质类固醇的依赖。这些发现表明阿尼鲁单抗是治疗具有挑战性的DLE病例的可行替代方案，需要进一步研究以证实其在更大人群中的疗效和安全性。
