Ann Dermatol.  2010 Aug;22(3):307-311. 10.5021/ad.2010.22.3.307.

Four Cases of Facial Discoid Lupus Erythematosus Successfully Treated with Topical Pimecrolimus or Tacrolimus

• Han YW
• Kim HO
• Park SH
• Park YM

• KMID: 2265364
• DOI: http://doi.org/10.5021/ad.2010.22.3.307

Abstract

Discoid lupus erythematosus (DLE), which is a cutaneous form of lupus erythematosus (LE), is generally refractory to a wide range of topical or systemic therapies. Although the main treatment option for DLE is topical steroids, it is often ineffective or likely to produce long-term side effects. New drugs, including tacrolimus and pimecrolimus, have been developed to overcome the adverse effects of steroids and treat the lesions of DLE for a prolonged period. We herein report 4 cases of facial DLE successfully treated with therapeutic adjuvants, topical tacrolimus or pimecrolimus.

Keyword

Discoid lupus erythematosus; Pimecrolimus; Tacrolimus

MeSH Terms

Lupus Erythematosus, Discoid
Steroids
Tacrolimus
Steroids
Tacrolimus

Figure

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  Fig. 1 Papulosquamous lesions of patients (cases 1: A, 2: B, 3: C, 4: D) with discoid lupus erythematosus before (a) and after treatment (b).

Reference

1. Rowell NR, Goodfield MJD. Champion RH, Burton JL, Burns DA, Breathnach SM, editors. Systemic lupus erythematosus. Textbook of dermatology. 1998. 6th ed. Oxford: Blackwell Science;2461–2500.

2. Bongu A, Chang E, Ramsey-Goldman R. Can morbidity and mortality of SLE be improved? Best Pract Res Clin Rheumatol. 2002. 16:313–332.

3. Fabbri P, Cardinali C, Giomi B, Caproni M. Cutaneous lupus erythematosus: diagnosis and management. Am J Clin Dermatol. 2003. 4:449–465.

4. Grassberger M, Baumruker T, Enz A, Hiestand P, Hultsch T, Kalthoff F, et al. A novel anti-inflammatory drug, SDZ ASM 981, for the treatment of skin diseases: in vitro pharmacology. Br J Dermatol. 1999. 141:264–273.

5. Eichenfield LF, Lucky AW, Boguniewicz M, Langley RG, Cherill R, Marshall K, et al. Safety and efficacy of pimecrolimus (ASM 981) cream 1% in the treatment of mild and moderate atopic dermatitis in children and adolescents. J Am Acad Dermatol. 2002. 46:495–504.

6. Ruzicka T, Bieber T, Schopf E, Rubins A, Dobozy A, Bos JD, et al. European Tacrolimus Multicenter Atopic Dermatitis Study Group. A short-term trial of tacrolimus ointment for atopic dermatitis. N Engl J Med. 1997. 337:816–821.

7. Harper J, Green A, Scott G, Gruendl E, Dorobek B, Cardno M, et al. First experience of topical SDZ ASM 981 in children with atopic dermatitis. Br J Dermatol. 2001. 144:781–787.

8. Ruzicka T, Assmann T, Homey B. Tacrolimus: the drug for the turn of the millennium? Arch Dermatol. 1999. 135:574–580.

9. Grimes PE, Soriano T, Dytoc MT. Topical tacrolimus for repigmentation of vitiligo. J Am Acad Dermatol. 2002. 47:789–791.

10. Bohm M, Frieling U, Luger TA, Bonsmann G. Successful treatment of anogenital lichen sclerosus with topical tacrolimus. Arch Dermatol. 2003. 139:922–924.

11. Kanekura T, Yoshii N, Terasaki K, Miyoshi H, Kanzaki T. Efficacy of topical tacrolimus for treating the malar rash of systemic lupus erythematosus. Br J Dermatol. 2003. 148:353–356.

12. Druke A, Gambichler T, Altmeyer P, Freitag M, Kreuter A. 0.1% Tacrolimus ointment in a patient with subacute cutaneous lupus erythematosus. J Dermatol Treat. 2004. 15:63–64.

13. Yoshimasu T, Ohtani T, Sakamoto T, Oshima A, Furukawa F. Topical FK506 (tacrolimus) therapy for facial erythematous lesions of cutaneous lupus erythematosus and dermatomyositis. Eur J Dermatol. 2002. 12:50–52.

14. Walker SL, Kirby B, Chalmers RJ. The effect of topical tacrolimus on severe recalcitrant chronic discoid lupus erythematosus. Br J Dermatol. 2002. 147:405–406.

15. de la Rosa Carrillo D, Christensen OB. Treatment of chronic discoid lupus erythematosus with topical tacrolimus. Acta Derm Venereol. 2004. 84:233–234.

16. Heffernan MP, Nelson MM, Smith DI, Chung JH. 0.1% tacrolimus ointment in the treatment of discoid lupus erythematosus. Arch Dermatol. 2005. 141:1170–1171.

17. Kreuter A, Gambichler T, Breuckmann F, Pawlak FM, Stucker M, Bader A, et al. Pimecrolimus 1% cream for cutaneous lupus erythematosus. J Am Acad Dermatol. 2004. 51:407–410.

18. Tlacuilo-Parra A, Guevara-Gutierrez E, Gutierrez-Murillo F, Soto-Ortiz A, Barba-Gomez F, Hernandez-Torres M, et al. Pimecrolimus 1% cream for the treatment of discoid lupus erythematosus. Rheumatology (Oxford). 2005. 44:1564–1568.