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Successful treatment of generalised discoid lupus erythematosus with imiquimod cream 5%: A case report and review of the literature
Enver Turan
; Assistant Professor, Department of Dermatology, Faculty of Medicine, University of Harran, 63200-Sanliurfa, Turkey
Isin Sinem Bagcı
; MD., Department of Dermatology, Istanbul Education and Research Hospital, Istanbul, Turkey
Asli Turgut Erdemir
; M.D., Department of Dermatology, Istanbul Education and Research Hospital, Istanbul, Turkey.
Mehmet Salih Gurel
; Assoc. Prof. Dep. Of Dermatology, Istanbul Education and Research Hospital, Istanbul, Turkey.
Abstract
Discoid lupus erythematosus (DLE) is the most common form of chronic cutaneous lupus erythematosus and tends to heal with scarring, hair loss and pigmentary changes if treatment is not initiated in the early phase of the disease. Classic DLE lesions are initially red-purple macules, papules or small plaques that rapidly acquire a hyperkeratotic appearance. Only a minority of the patients with DLE progress to develop systemic lupus erythematosus (SLE). A small percentage of patients with SLE have concomitant DLE. However, generalised DLE is more frequently associated with systemic involvement than classic DLE. The diagnosis of DLE is usually based on clinical features, although in some cases histopathologic examination may be required to confirm the diagnosis. Standard therapy for cutaneous lupus includes broad-spectrum sunscreens, topical and intralesional glucocorticoids and antimalarial agents. A 63-year-old man presented with erythematous scaly patches that he had had on his face for approximately eight months. Although it was mainly his face that was affected, lesions were also noted on his scalp, neck, chest, shoulder, upper arms and trunk. Histopathologic examination verified the diagnosis of DLE. No systemic involvement was detected through laboratory examinations or consultations with the other departments. Imiquimod cream 5% was applied three times a week, every other week. After 24 applications over a period of two months an almost complete improvement was achieved. Topical imiquimod may, then, be an alternative treatment for generalised DLE.
Keywords
Hrčak ID:
125602
URI
Publication date:
28.7.2014.
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