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Review
. 2013 Sep;25(5):584-90.
doi: 10.1097/BOR.0b013e32836437ba.

Update on pathogenesis and treatment of CLE

Emily D Privette  1 , Victoria P Werth
Affiliations
Review

Update on pathogenesis and treatment of CLE

Emily D Privette et al. Curr Opin Rheumatol. 2013 Sep.

Abstract

Purpose of review: Cutaneous Lupus Erythematous (CLE) is an autoimmune disease in which patients may present with isolated skin findings or have CLE associated with underlying systemic disease. The most significant recent studies on its pathogenesis and therapeutic management are reviewed here.

Recent findings: Patients with subacute and Discoid Lupus Erythematous had elevated Interferon score, about a third of all cases of SCLE could be attributed to previous drug exposure, and smoking may be more closely associated with CLE than Systemic Lupus Erythematous (SLE). An underlying genetic defect in some subsets of CLE patients may also be shared with SLE. Efficacy of antimalarial therapy is enhanced by increasing treatment duration or maintaining higher blood drug concentrations. Combination antimalarials that include quinacrine, thalidomide analogs, and Mycophenalate Mofetil may also be effective in refractory CLE.

Summary: The pathogenesis of CLE remains unclear, and is likely multifactorial. Identified associations with subsets of CLE suggest future research questions in CLE pathogenesis. Subsets of CLE associated with interface dermatitis may share an underlying genetic defect in interferon signaling with SLE. The Cutaneous Lupus Disease Area and Severity Index is a valuable and widely used tool allowing standardized assessment and reporting of cutaneous disease activity and damage. More evidence is available to guide treatment of refractory CLE, but larger studies are needed.

Video abstract: http://links.lww.com/COR/A4.

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Conflict of interest statement

Conflicts of interest: This material is based upon work supported by a Merit Review Grant from the Department of Veterans Affairs (Veterans Health Administration, Office of Research and Development, Biomedical Laboratory Research and Development) and by the National Institutes of Health (NIH K24-AR 02207) to V.P.W.

The Copyright for the CLASI is owned by the University of Pennsylvania.

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