Lupus erythematosus tumidus : response to antimalarial treatment in 36 patients with emphasis on smoking
OBJECTIVE: To determine the efficacy of antimalarial drug use in patients with lupus erythematosus tumidus.
DESIGN: Retrospective single-center study.
SETTING: Dermatologic clinic at a university hospital.
PATIENTS: Thirty-six patients with multifocal lupus erythematosus tumidus. Intervention Treatment with either chloroquine phosphate or hydroxychloroquine sulfate.
MAIN OUTCOME MEASURES: Cutaneous Lupus Erythematosus Disease Area and Severity Index score.
RESULTS: Treatment with antimalarial drugs resulted in a significant reduction in the Cutaneous Lupus Erythematosus Disease Area and Severity Index score, from 4 (range, 2-8) at baseline to 1 (range, 0-6) after 3 months of therapy (P < .001). Twenty-two patients (61%) exhibited complete or almost complete clearance of skin lesions, consistent with a clinical score of 0 or 1. No difference in efficacy was noted between the chloroquine-treated group and the hydroxychloroquine-treated group (P = .40). Adverse effects (nausea, dizziness, and headache) occurred only in patients treated with chloroquine. Twenty-eight patients (78%) were smokers, and smokers had a significantly higher mean (SD) clinical score than nonsmokers (5.1 [1.8] vs 3.3 [1.6]; P = .03). Moreover, smokers had a significantly lower reduction in clinical score with antimalarial treatment compared with nonsmokers (r = 0.30; P = .03; 95% confidence interval, -0.05 to 0.57). Eighty-eight percent of nonsmokers (7 of 8 patients) but only 57% of smokers (16 of 28 patients) had a clinical score of 1 or 0 after 3 months of treatment with antimalarial drugs.
CONCLUSIONS: These retrospective study findings demonstrate that antimalarial treatment is highly effective in multifocal lupus erythematosus tumidus. Lower incidence of adverse effects and equal efficacy might favor the use of hydroxychloroquine. Patients who smoke should be encouraged to join smoking cessation programs because they will respond better to antimalarial treatment.
| Errataetall: |
CommentIn: Arch Dermatol. 2009 Mar;145(3):316-9. - PMID 19289766 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2009 |
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| Erschienen: |
2009 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:145 |
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| Enthalten in: |
Archives of dermatology - 145(2009), 3 vom: 17. März, Seite 244-8 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kreuter, Alexander [VerfasserIn] |
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| Links: |
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| Themen: |
4QWG6N8QKH |
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| Anmerkungen: |
Date Completed 10.04.2009 Date Revised 21.11.2013 published: Print CommentIn: Arch Dermatol. 2009 Mar;145(3):316-9. - PMID 19289766 Citation Status MEDLINE |
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| doi: |
10.1001/archdermatol.2008.592 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM187115591 |
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| 245 | 1 | 0 | |a Lupus erythematosus tumidus |b response to antimalarial treatment in 36 patients with emphasis on smoking |
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| 500 | |a Date Revised 21.11.2013 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Arch Dermatol. 2009 Mar;145(3):316-9. - PMID 19289766 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To determine the efficacy of antimalarial drug use in patients with lupus erythematosus tumidus | ||
| 520 | |a DESIGN: Retrospective single-center study | ||
| 520 | |a SETTING: Dermatologic clinic at a university hospital | ||
| 520 | |a PATIENTS: Thirty-six patients with multifocal lupus erythematosus tumidus. Intervention Treatment with either chloroquine phosphate or hydroxychloroquine sulfate | ||
| 520 | |a MAIN OUTCOME MEASURES: Cutaneous Lupus Erythematosus Disease Area and Severity Index score | ||
| 520 | |a RESULTS: Treatment with antimalarial drugs resulted in a significant reduction in the Cutaneous Lupus Erythematosus Disease Area and Severity Index score, from 4 (range, 2-8) at baseline to 1 (range, 0-6) after 3 months of therapy (P < .001). Twenty-two patients (61%) exhibited complete or almost complete clearance of skin lesions, consistent with a clinical score of 0 or 1. No difference in efficacy was noted between the chloroquine-treated group and the hydroxychloroquine-treated group (P = .40). Adverse effects (nausea, dizziness, and headache) occurred only in patients treated with chloroquine. Twenty-eight patients (78%) were smokers, and smokers had a significantly higher mean (SD) clinical score than nonsmokers (5.1 [1.8] vs 3.3 [1.6]; P = .03). Moreover, smokers had a significantly lower reduction in clinical score with antimalarial treatment compared with nonsmokers (r = 0.30; P = .03; 95% confidence interval, -0.05 to 0.57). Eighty-eight percent of nonsmokers (7 of 8 patients) but only 57% of smokers (16 of 28 patients) had a clinical score of 1 or 0 after 3 months of treatment with antimalarial drugs | ||
| 520 | |a CONCLUSIONS: These retrospective study findings demonstrate that antimalarial treatment is highly effective in multifocal lupus erythematosus tumidus. Lower incidence of adverse effects and equal efficacy might favor the use of hydroxychloroquine. Patients who smoke should be encouraged to join smoking cessation programs because they will respond better to antimalarial treatment | ||
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| 700 | 1 | |a Tigges, Christian |e verfasserin |4 aut | |
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| 700 | 1 | |a Altmeyer, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Gambichler, Thilo |e verfasserin |4 aut | |
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