Cutaneous lupus erythematosus induced by drugs - novel insights

ABSTRACT

Introduction: There is a growing list of drugs implicated in inducing both subacute and chronic forms of cutaneous lupus erythematosus. It is important to recognize these drugs in order to quickly treat patients with drug induced disease.

Areas covered: This paper reviews the current literature describing drugs implicated in causing cutaneous lupus erythematosus. A Pubmed search was used to compile a list of medications implicated up to August 2019. It reviews new classes of drugs identified as causing cutaneous lupus erythematosus, the pathophysiology of the disease process, and current recommendations for treatment of the disease.

Expert opinion: Many drugs have been identified as inducing lupus, and many more continue to be described in new reports. Further research is needed to understand this phenomenon, which will aid in the diagnosis and treatment of affected patients.

KEYWORDS:

• Drug induced lupus
• cutaneous lupus erythematosus
• subacute cutaneous lupus
• chronic cutaneous lupus
• cutaneous lupus diagnosis
• cutaneous lupus treatment

Article highlights

• Drug induced cutaneous lupus is well recognized, though remains poorly understood.

• It is difficult, if not impossible, to differentiate from idiopathic cutaneous lupus.

• A number of drugs can induce the disease, including many newly developed biologic and chemotherapeutic agents.

• Therapy involves removal of the offending agent and occasionally topical steroids, systemic antimalarials, or systemic steroids.

• Future research is needed to understand how these drugs affect the pathogenesis of lupus, which may have implications for treatment and drug development in lupus.

Declaration of interest

VP Werth discloses receiving funding from the Department of Veterans Affairs and National Institute of Health. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This project is supported by the Department of Veterans Affairs Veterans Health Administration, Office of Research and Development, Biomedical Laboratory Research and Development and National Institutes of Health (National Institute of Arthritis and Musculoskeletal and Skin Diseases) R01AR071653 (VP Werth).