Subacute cutaneous lupus erythematosus

Patients with subacute cutaneous lupus erythematosus appear to have a disease distinct from discoid and systemic lupus erythematosus.
Lesions, most prominent in sun-damaged skin, consist of non-scarring papulosquamous lesions which are often polycyclic. Classic DLE lesions though may be found in some patients. Some criteria of SLE may also be present.
Unlike discoid lupus erythematosus, follicular plugging is not a prominent feature.
Arthritis is a common feature.
Anti-Ro and anti-La are frequently positive.
SCLE may be triggered by drugs such as hydrochlorothiazide and griseofulvin. Children born to mothers with SCLE may have neonatal LE.

Treatment:

• Broad spectrum sunscreens blocking both UVA and UVB are the base of treatment.
• Topical potent glucocorticoids such as clobetasol 0.05% cream bid may be required although some patients respond well to milder steroids.
• Anti-malarials such as hydroxychloroquine sulfate 400 mg bid may be required. As treatment may be required for long periods of time, note should be taken of the potential systemic side effects of hydroxychloroquine sulfate, including retinopathy.

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