Clinical, Cosmetic and Investigational Dermatology (Sep 2022)
Advancements in the Treatment of Cutaneous Lupus Erythematosus and Dermatomyositis: A Review of the Literature
Abstract
Kareem G Elhage,1 Raymond Zhao,2 Mio Nakamura3 1University of California San Francisco, San Francisco, CA, USA; 2University of Michigan, Ann Arbor, MI, USA; 3Department of Dermatology, University of Michigan, Ann Arbor, MI, USACorrespondence: Kareem G Elhage, 515 Spruce Street, San Francisco, CA, 94118, USA, Email [email protected]: Cutaneous lupus erythematosus (CLE) and dermatomyositis (DM) are autoimmune diseases that present with a wide variety of cutaneous manifestations. In both cases, first-line therapy includes topical corticosteroids. Patients may present with more widespread disease requiring systemic treatments, including corticosteroids, traditional immunosuppressants, or antimalarials. Due to their complex nature, both CLE and DM remain difficult to treat and continue to cause significant distress to patients.Objective: To summarize the most recent literature on the safety and efficacy of novel treatment modalities for CLE and DM.Methods: A literature search was conducted on PubMed using search terms “(dermatomyositis) AND (treatment)” and “(cutaneous lupus) AND (treatment)”. Additional search terms included specific names of biologic agents, phosphodiesterase inhibitors (apremilast), and JAK inhibitors.Results: JAK inhibitors, PDE-4 inhibitors, and biologics have shown promise in reducing cutaneous symptoms of both CLE and DM, including reduction in SLE Disease Activity Index 2000 (SLEDAI-2K), Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI), British Isles Lupus Assessment Group (BILAG), Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI), and Disease Activity Score (DAS).Conclusion: While there have been recent advancements in the treatment for CLE and DM, further research and clinical trials are required to better elucidate which therapy is best for individual patients.Keywords: biologics, cutaneous lupus erythematosus, dermatomyositis, JAK inhibitors, PDE-4 inhibitors
