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December 1993

Chronic Cutaneous Lupus Erythematosus Treated With Thalidomide

Author Affiliations

University of Rochester (NY) Medical Center

Arch Dermatol. 1993;129(12):1548-1550. doi:10.1001/archderm.1993.04540010026002

REPORT OF A CASE  A 38-year-old woman presented with extensive scarring alopecia diagnosed as chronic cutaneous lupus erythematosus (CCLE) at age 21 years. A skin biopsy specimen confirmed the diagnosis, and repeated studies failed to reveal anti-nDNA (double-stranded or native), anti-Ro (SSA), or anti-La (SS-B) antibodies. She denied photosensitivity, arthralgias, pericarditis, pleurisy, renal or hematologic disease, or psychiatric disorders.Half of the scalp was involved, with an extensive atrophic scarring alopecia that demonstrated patchy hyperpigmentation, hypopigmentation, and erythema (Figure 1). Scattered follicular plugs were also present.The patient received quinacrine (Atabrine) (100 mg twice daily) from October 1983 through May 1987. In October 1985, hydroxychloroquine (Plaquenil Sulfate) was added to therapy, with the dose increasing from 200 to 400 mg/d. Hydroxychloroquine therapy was discontinued in April 1989, and dapsone (50 mg/d) was substituted in June 1989 for 8 weeks. Isotretinoin (Accutane)

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