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Treatment of cutaneous lupus may include medications and lifestyle changes

There is no cure for cutaneous lupus. However, this chronic skin disease can be controlled with medications and lifestyle changes, such as limiting sun exposure.

6 ways to treat cutaneous lupus

1. Sun avoidance
   1. Sun protection is an important proactive measure to prevent cutaneous lupus flares caused by ultraviolet radiation.
   2. Physical sunscreens (clothes, wide-brimmed hats) and chemical sunscreens (lotions, gels) are effective at blocking harmful ultraviolet radiation that can trigger lupus-related rashes.
2. Steroids
   1. Steroids are anti-inflammatory agents that can be used orally, topically (applied directly on the skin), or as injections into the skin lesions.
   2. Prednisone is an oral corticosteroid often used to treat cutaneous lupus lesions by calming the overactive inflammatory response.
3. Tacrolimus or pimecrolimus
   1. These are calcineurin inhibitors that are effective for skin lesions when used topically.
   2. However, the medications in pill form have been linked to certain cancers.
4. Mycophenolate mofetil, azathioprine, and methotrexate
   1. These immunosuppressive medications are used as long-term options for patients with cutaneous lupus who are attempting to wean themselves off oral steroids.
   2. The medications are thought to reduce the production of inflammatory cells.
5. Thalidomide
   1. This is an inhibitor of a cytokine called TNF-α that works by impeding the activity of this cytokine. This, in turn, decreases the severity of the immune response.
6. Antimalarial drugs
   1. Studies suggest hydroxychloroquine works for about 60% of people with cutaneous lupus.
   2. Side effects of these drugs tend to be less serious than other oral medications.

What is cutaneous lupus?

Cutaneous lupus erythematosus is the skin-related form of lupus that most commonly affects people with systemic lupus erythematosus (SLE). Approximately 85% of people with SLE will have a cutaneous manifestation at some point during their disease.

It affects millions of people worldwide, most commonly in their third and fourth decades of life. Women are twice more likely to be affected than men.

How is cutaneous lupus diagnosed?

Diagnosis of cutaneous lupus requires proper classification of the subtype through a combination of:

• Physical examination
• Laboratory studies
• Histology (skin biopsy)
• Antibody serology 
• Direct immunofluorescence test (occasionally)