THERAPEUTIC MANAGEMENT OF SYSTEMIC LUPUS ERYTHEMATOSUS (SLE) WITH CUTANEOUS INVOLVEMENT: TOPICAL AND SYSTEMIC APPROACH

Abstract

Cutaneous lupus erythematosus (CLE) is a common cutaneous manifestation of systemic lupus erythematosus (SLE), characterized by a wide range of lesions that can be acute, subacute, or chronic, depending on the subtype. The pathogenesis of CLE involves genetic, environmental, and immunological factors, with ultraviolet radiation being one of the main triggers for the development of cutaneous lesions. Clinical manifestations may include rashes, alopecia, and nail changes, with malar erythema being one of the most characteristic signs. Early identification and accurate classification of lesions are essential for diagnosis and to determine the severity of systemic involvement. Treatment of CLE is challenging, with conventional therapies such as hydroxychloroquine (HCQ) and mycophenolate mofetil (MMF) frequently used, although newer agents such as anifrolumab have shown promising potential for refractory cases. The use of anifrolumab has been associated with a significant improvement in cutaneous symptoms, mainly in subtypes such as discoid lupus erythematosus (DLE) and subacute cutaneous lupus erythematosus (SCLE). This review explores advances in treatments and highlights the need for more effective therapeutic strategies, considering the multiple manifestations and complexity of SCLE (Fijałkowska; Kądziela; Żebrowska, 2024; Bao et al., 2023).