Pınar ÖZTAŞ, Esra ADIŞEN, Mehmet Ali GÜRER, Meltem ÖNDER

Successful treatment of severe discoid lupus erythematosus with azathioprine: A case report

Diskoid Lupus Eritematozus (DLE), keskin sınırlı, eritemli skuamlı at-rofık, diskoid plaklarla seyreden kronik bir hastalıktır. DLE tedavisinde sistemik steroidler, hidroksiklorokin, dapson, mikofenolat mofetil ve re-tinoidler kullanılmaktadır. Tedaviye dirençli ve şiddetli olguların tedavisi ise halen sorun olmaktadır. Bu yayında tedaviye dirençli ve şiddetli bir DLE olgusu ve azotiyoprinle başarılı tedavisi sunulmaktadır.

Tedaviye dirençli diskoid lupus eritematozusun azotiyoprinle başarılı tedavisi: Bir vaka sunumu

Discoid lupus erythematosus (DLE) is a chronic, indolent skin disease characterized by sharply marginated, scaly, atrophic, red, discoid plaques. Although there are many treatment modalities for DLE, such as systemic steroids, hydroxychloroquine, dapson, mycophenolate mofetil and retinoids, the therapy for resistant and severe cases is still a problem. In this report, we present a severe, resistant DLE case treated successfully with azathioprine.

PDF

___

1.Fabbri P, Cardinali C, Giomi B, Caproni M. Cutaneous lupus erythematosus: diagnosis and management. Am J Clin Dermatol 2003; 4: 449-465.
2.Pramatarov KD. Chronic cutaneous lupus erythematosus—clinical spectrum. Clin Dermatol 2004; 22: 113-120.
3.Callen JP. Management of skin disease in patients with lupus erythematosus. Best Prac Res Clin Rheumatol 2002; 16: 245-260.
4.Goyal S, Nousari HC. Treatment of resistant discoid lupus erythematosus of the palms and soles with mycophenolate mofetil. J Am Acad Dermatol 2001; 45: 142-144.
5.Ashinoff R, Werth VP, Franks AG. Resistant discoid lupus erythematosus of palms and soles: successful treatment with azathioprine. J Am Acad Dermatol 1988; 19: 961-965.
6.Jessop S, Whitelaw D, Jordaan F. Drugs for discoid lupus erythematosus. Cochrane Database Syst Rev 2001; 1: CD002954.
7.Callen JP. Treatment of cutaneous lesions in patients with lupus erythematosus. Dermatol Clin. 1994; 12: 201-206.
8.Ueki H. Köbner-Phânomen bei lupus eiythematodes. Hautarzt 1994; 45: 154-160.
9.Tsokos GC, Caugham SW, Klippel JH. Successful treatment of generalized discoid skin lesions with azathioprine. Its use in a patient with systemic lupus erythematosus. Arch Dermatol 1985; 121: 1323-1325.
10.Shehade S. Successful treatment of generalized discoid skin lesions with azathioprine. Arch Dermatol 1986; 122: 376-377.
11.Werth V, Franks A. Treatment of discoid skin lesions with azathioprine. Arch Dermatol 1986; 12: 746-747.
12.Callen JP, Spencer LV, Burruss JB, Holtman J. Azathioprine: an effective, corticosteroids-sparing therapy for patients with recalcitrant cutaneous lupus erythematosus or with recalcitrant cutaneous leucocytoclastic vasculitis. Arch Dermatol 1991; 127: 515-522.
13.Anstey VA, Wakelin S, Reynolds NR. Guidelines for prescribing azathioprine in dermatology. British Journal of Dermatology 2004- 151: 1123-1132.
14.Younger IR, Harris DW, Colver GB. Azathioprine in dermatology,J Am Acad Dermatol 1991; 25: 281-286.
15.Boehm I, Bieber T. Chilblain Lupus Erythematosus Hutchinson: Successful treatment with mycophenolate mofetil. Arch Dermatol 2001; 137:235-236.
16.Goodfield M, Davison K, Bowden K. Intravenous immunoglobulin (IVIG) for therapy-resistant cutaneous lupus erythematosus (LE). J Dermatol Treat 2004; 15: 46-50.
17.Walker SL, Kirby B, Chalmers RJG. The effect of topical tacrolimus on severe recalcitrant chronic discoid lupus erythematosus. Br J Dermatol 2002; 147: 405-406.
18.Ruzicka T, Meurer M, Brown-Falco O. Treatment of cutaneous lupus erythematosus with etretinate. Acta Derm Venereol 1985; 65: 324-349.