Characteristics and Alternative Treatment Outcomes of Antimalarial-Refractory Cutaneous Lupus Erythematosus | Dermatology | JAMA Dermatology | JAMA Network
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Research Letter
September 2017

Characteristics and Alternative Treatment Outcomes of Antimalarial-Refractory Cutaneous Lupus Erythematosus

Author Affiliations
  • 1Ronald O. Perelman Department of Dermatology, New York University Langone Medical Center, New York, New York
  • 2Department of Dermatology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
JAMA Dermatol. 2017;153(9):937-939. doi:10.1001/jamadermatol.2017.1160

Cutaneous lupus erythematosus (CLE) is an autoimmune skin disease associated with substantial morbidity.1 Although antimalarial therapy is considered to be first-line systemic treatment, as many as 50% of patients have recalcitrant disease.2 Alternative therapies have been investigated for antimalarial-refractory CLE, but the existing literature is limited to small studies without comparative treatment data.1 We therefore sought to evaluate the characteristics and treatments of antimalarial-refractory CLE.

We performed a query-based search of medical records from New York University Langone Medical Center, New York; Bellevue Hospital Center, New York, New York; Brigham and Women’s Hospital, Boston, Massachusetts; and Massachusetts General Hospital, Boston, to identify patients with antimalarial-refractory CLE from January 1, 2000, through December 31, 2015. Antimalarial-refractory disease was defined as no clinical response (CR) (no improvement in erythema, scaling, and alopecia) or partial CR (<50% improvement) to standard doses of at least 1 antimalarial therapy for at least 3 months. Deidentified clinical and treatment data were extracted, and categorical variables were compared using 2-tailed χ2 tests with Bonferroni post hoc analysis (P ≤ .05). This study was approved by the institutional review boards of all participating institutions.