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Local therapy for cutaneous and systemic lupus erythematosus: practical and theoretical considerations

Resident in Dermatology, Department of Dermatology, University of Iowa Health Care, Iowa City, Iowa, USA

R D Sontheimer

Department of Dermatology, University of Iowa Health Care, Iowa City, Iowa, USA

Local therapeutic measures should be maximized in the management of lupus erythematosus (LE), particularly for patients with forms of LE-specific skin disease such as SCLE and CCLE. Local therapy consists of sun protection and locally-applied pharmacologic agents, eg topical/intralesional corticosteroids. Patients should be advised to avoid direct sun exposure, wear lightweight tightly woven clothing and broad-brimmed hats, and use broad-spectrum, water-resistant sunscreens. There are several modalities that enhance permeability of local therapeutics through the stratum corneum that could be applied to topical therapy of cutaneous LE, eg polar solvent, liposomal encapsulation, ethosomal system, iontophoresis, electroporation and sonophoresis. As novel and more effective modalities to deliver pharmacologic agents across the stratum corneum become available, therapeutics that have been experimental and untested thus far may become part of the local armamentarium in the near future. In addition, physical/contact therapy as well as dermatosurgical methods can be invaluable in enhancing self-image and quality of life of patients with disfiguring cutaneous LE lesions.

Key Words: LE-specific skin disease • cutaneous LE • subacute cutaneous LE • chronic cutaneous LE (discoid LE) • local therapy • topical therapy • sunscreens, uv protection, percutaneous penetration • photosensitivity • sun protection • stratum corneum barrier

Lupus, Vol. 10, No. 3, 171-184 (2001)
DOI: 10.1191/096120301667674688


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