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Antimalarials in cutaneous lupus erythematosus: mechanisms of therapeutic benefit

Department of Dermatology, Medical University of Lodz, Lodz, Krzemieniecka, Poland

A Carter

Medical School, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

D P Mccauliffe

Department of Medicine, Division of Dermatology, Box 3135, Duke University Medical Center, Durham, NC 27710, USA,dpmccauliffe{at}juno.com

Antimalarials are arguably the best modality currently available for treating patients with cutaneous lupus erythematosus (LE). Although antimalarials have been used for decades in treating cutaneous LE, the precise mechanisms by which they provide therapeutic benefit are not well defined. The putative mechanisms by which antimalarials might provide therapeutic benefit to patients with cutaneous LE include a number of interrelated anti-inflammatory and immunosuppressive effects that include photoprotection, lysosomal stabilization, suppression of antigen presentation, and inhibition of prostaglandin and cytokine synthesis. If we had a more precise understanding of how antimalarials provide therapeutic benefit in cutaneous LE we might gain better insight into the pathogenic mechanisms of LE and ways of developing better therapies for afflicted patients.

Key Words: LE • cutaneous • antimalarials • hydroxychloroquine • chloroquine

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