Dermatology

Systemic lupus erythematosus

Questions discussed in this category

How would you approach management of a patient with longstanding history of SLE, but having active psoriasis?

SLE manifestations include arthralgias and cytopenias which are stable. Previously did well on methotrexate, but developed GI side effects. HCQ is on ...

3 Answers available

What is your approach for severe SCLE in patients unable to tolerate HCQ?

3 Answers available

How would you approach management of a young male patient with discoid lupus who has had minimal response to hydroxychloroquine (and subtherapeutic whole blood levels) who continues to use tobacco products?

2 Answers available

Would you switch azathioprine to a different immunosuppressant if a controlled patient with SLE develops melanoma and/or non-melanoma skin cancer?

2 Answers available

Any concern for lupus flare in patients undergoing laser hair removal?

2 Answers available

What is your approach to patients with SLE who develop a rash after hydroxychloroquine initiation?

3 Answers available

How do you manage recurrent urticarial lesions in a patient with underlying connective tissue disease that is otherwise well-controlled?

3 Answers available

What is your approach to severe discoid lupus refractory to conventional topical and systemic therapies?

(Refractory to mycophenolate, azathioprine, and methotrexate. UpToDate suggests thalidomide or IVIG with mixed efficacy, while there are some case rep...

5 Answers available

Have you seen drug induced SCLE from IL-17 inhibitors?

And if so, what is your approach to the diagnosis?

1 Answer available

How will you utilize newly FDA approved anifrolumab for SLE in your practice?

2 Answers available

How do you monitor patients with cutaneous lupus for progression to SLE?

Do you do blood work? Or do you rely on review of systems?

1 Answer available

How do you approach treating patients with lupus profundus?

Do you typically start the patient on hydroxychloroquine? What work-up do you perform?

1 Answer available

Do you measure drug levels (particularly hydroxychloroquine or mycophenolate) in your lupus patients?

Several speakers at ACR 2021 commented on the important role of drug levels in the management of these patients and cautioned against adding medicatio...

1 Answer available

What is your treatment approach to persistent chillblains lesions in the absence of systemic lupus?

1 Answer available

Do you routinely check G6PD level prior to initiation of hydroxychloroquine?

6 Answers available

What is your approach to ongoing assessment and medication tapering in well controlled discoid lupus without systemic features?

3 Answers available

How do you approach the treatment of bullous cutaneous lupus?

When would you de-escalate therapy?

1 Answer available

How do you approach the use of commercial testing such as AVISE CTD in clinical practice?

1 Answer available

How do you clinically distinguish between cutaneous lupus with photosensitivity and polymorphic light eruption-like reactions?

1 Answer available

Is it ever reasonable to switch to a different TNFi as opposed to switching to an agent in a different class in a case of TNFi induced lupus or psoriasis?

In other words, do we think of TNFi induced lupus and TNFi induced psoriasis as a drug effect or a class effect?

1 Answer available

When is it necessary to monitor the QTc interval in patients on hydroxychloroquine?

2 Answers available

Is it okay to use medications associated with drug-induced lupus in patients with SLE?

1 Answer available

Is there a role for measuring hydroxychloroquine blood levels in clinical practice?

If so, are there specific patient populations for which you would use this metric?

1 Answer available

Are you recommending the mRNA COVID-19 vaccines to your patients with immune mediated inflammatory diseases?

5 Answers available

Which immunosuppressed patients with SLE would benefit from antibiotic prophylaxis to prevent pneumocystis pneumonia?

1 Answer available

Is it ever appropriate to use hydroxychloroquine temporarily in higher doses (more than 5mg/kg) to control lupus activity such as skin manifestations?

1 Answer available

Do you continue hydroxychloroquine in lupus patients who develop cardiomyopathy?

1 Answer available

What is your approach to bladder cancer surveillance in patients who have received cyclophosphamide?

1 Answer available

Are there any clinical situations in which checking for anti-chromatin antibodies is helpful?

1 Answer available

How do you counsel patients who ask if there are any dietary modifications they can make to help control their autoimmune disease?

This question is part of a collaboration with RheumMadness and is specifically in reference to: ADIRA Diet

1 Answer available

Is there a minimum work-up necessary in patients with an ANA greater than 1:160 and no clinical symptoms suggestive of lupus (i.e., specific antibodies, UA)?

2 Answers available

Do you use hydroxychloroquine for prevention of neonatal lupus in patients with a positive SSA who are planning on becoming pregnant?

1 Answer available

Papers discussed in this category

J. Am. Coll. Cardiol.,

Hydroxychloroquine to Prevent Recurrent Congenital Heart Block in Fetuses of Anti-SSA/Ro-Positive Mothers.

Arthritis and rheumatism, 1982-11

The 1982 revised criteria for the classification of systemic lupus erythematosus.

Arthritis and rheumatism, 2012-08

Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus.

, 2019 Aug 06

2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus.

Arthritis Rheum.,

Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus.

Arthritis and rheumatism, 2010-01

Incidence and prevention of bladder toxicity from cyclophosphamide in the treatment of rheumatic diseases: a data-driven review.

J. Rheumatol., 2019 Sep 01

Malignancies in Patients with Antineutrophil Cytoplasmic Antibody-associated Vasculitis: A Population-based Cohort Study.

JAMA ophthalmology, 2014-12

The risk of toxic retinopathy in patients on long-term hydroxychloroquine therapy.

Can J Ophthalmol,

Retinal toxicity of high-dose hydroxychloroquine in patients with chronic graft-versus-host disease.

J Am Acad Dermatol, 2016 Feb 03

The effect of increasing the dose of hydroxychloroquine (HCQ) in patients with refractory cutaneous lupus erythematosus (CLE): An open-label prospective pilot study.

Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2008-10

Prophylactic antibiotic usage for Pneumocystis jirovecii pneumonia in patients with systemic lupus erythematosus on cyclophosphamide: a survey of US rheumatologists and the review of literature.

Clin Rheumatol, 2006 Dec 21

Infection-related morbidity and mortality in patients with connective tissue diseases: a systematic review.

Int J Clin Pract, 2021 Mar 24

Effect of COVID-19 medications on corrected QT interval and induction of torsade de pointes: Results of a multicenter national survey.

Mod Rheumatol, 2021 Feb 09

QTc interval prolongation in patients with systemic lupus erythematosus treated with hydroxychloroquine.

Heart Rhythm, 2020 Jun 28

Effects of hydroxychloroquine treatment on QT interval.

Arthritis care & research, 2018-03

Examination of Hydroxychloroquine Use and Hemolytic Anemia in G6PDH-Deficient Patients.

J Clin Rheumatol, 2020 Sep 18

Association of Hydroxychloroquine use and Hemolytic Anemia in Patients With Low Levels of Glucose-6-Phosphate Dehydrogenase.

Cureus, 2020 Aug 02

A Study on the Relevance of Glucose-6-Phosphate Dehydrogenase Level Screening in Patients with Rheumatic Diseases Prior to Initiating Treatment With Hydroxychloroquine.

Autoimmunity reviews, 2009-02

The risk of ultraviolet radiation exposure from indoor lamps in lupus erythematosus.

Arthritis and rheumatism, 2013-07

Vitamin D in systemic lupus erythematosus: modest association with disease activity and the urine protein-to-creatinine ratio.

Arthritis Rheumatol, 2021 Mar 24

Long-Term Safety and Efficacy of Anifrolumab in Adults With Systemic Lupus Erythematosus: Results of a Phase II Open-Label Extension Study.

Rev Med Interne, 2016 Oct 13

[Blood concentration of hydroxychloroquine in systemic lupus erythematosus care: Usefulness and limits].

Arthritis Care Res (Hoboken), 2021 Mar 30

Clinical Significance of Monitoring Hydroxychloroquine Levels in Patients With Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis.

JAMA Dermatol,

Hydroxychloroquine-induced pigmentation in patients with systemic lupus erythematosus: a case-control study.

Mod Rheumatol, 2020 Sep 17

Anifrolumab, a monoclonal antibody to the type I interferon receptor subunit 1, for the treatment of systemic lupus erythematosus: an overview from clinical trials.

Ann Rheum Dis, 2014 Feb 13

The number of flares patients experience impacts on damage accrual in systemic lupus erythematosus: data from a multiethnic Latin American cohort.

Ann Rheum Dis, 2019 Jan 04

Organ damage in patients treated with belimumab versus standard of care: a propensity score-matched comparative analysis.

Ann Rheum Dis, 2014 Apr 16

Treat-to-target in systemic lupus erythematosus: recommendations from an international task force.

N Engl J Med, 2019 Dec 18

Trial of Anifrolumab in Active Systemic Lupus Erythematosus.

Seminars in arthritis and rheumatism, 2010-12

Psoriatic skin lesions induced by tumor necrosis factor antagonist therapy: clinical features and possible immunopathogenesis.

Clin Exp Rheumatol, 2012 Oct 17

Anti-tumour necrosis factor alpha therapy and increased risk of de novo psoriasis: is it really a paradoxical side effect?

Inflamm Bowel Dis,

Tumor necrosis factor α antagonist-associated psoriasis in inflammatory diseases: an analysis of the FDA adverse event reporting system.

Am J Clin Dermatol,

Tumor necrosis factor-alpha inhibitor-induced psoriasis or psoriasiform exanthemata: first 120 cases from the literature including a series of six new patients.

Lupus science & medicine, 2014

Cell-bound complement activation products in systemic lupus erythematosus: comparison with anti-double-stranded DNA and standard complement measurements.

The Journal of rheumatology, 2015-11

Hydroxychloroquine Blood Levels in Systemic Lupus Erythematosus: Clarifying Dosing Controversies and Improving Adherence.

Ophthalmology, 2016-06

Recommendations on Screening for Chloroquine and Hydroxychloroquine Retinopathy (2016 Revision).

Lupus science & medicine, 2017

Cell-bound complement activation products in SLE.

Journal of immunology research, 2017

Performance Characteristics of Different Anti-Double-Stranded DNA Antibody Assays in the Monitoring of Systemic Lupus Erythematosus.

Lupus science & medicine, 2018

Erythrocyte-bound C4d in combination with complement and autoantibody status for the monitoring of SLE.

Arthritis care & research, 2019-07

Area-Level Predictors of Medication Nonadherence Among US Medicaid Beneficiaries With Lupus: A Multilevel Study.

Clin Pharmacol Ther, 2018 Jun

A Prospective International Study on Adherence to Treatment in 305 Patients With Flaring SLE: Assessment by Drug Levels and Self-Administered Questionnaires.

Lupus Sci Med, 2016

Reduction in erythrocyte-bound complement activation products and titres of anti-C1q antibodies associate with clinical improvement in systemic lupus erythematosus.

Lupus Sci Med, 2016 Feb 01

Systemic lupus erythematosus and primary fibromyalgia can be distinguished by testing for cell-bound complement activation products.

Lupus Sci Med,

A multianalyte assay panel with cell-bound complement activation products demonstrates clinical utility in systemic lupus erythematosus.

ACR Open Rheumatol, 2020 Oct 12

Evaluation of the Economic Benefit of Earlier Systemic Lupus Erythematosus (SLE) Diagnosis Using a Multivariate Assay Panel (MAP).

Arthritis Rheumatol, 2021 May 02

Association of Higher Hydroxychloroquine Blood Levels With Reduced Thrombosis Risk in Systemic Lupus Erythematosus.

Ann Rheum Dis, 2012 Nov 10

Hydroxychloroquine in systemic lupus erythematosus: results of a French multicentre controlled trial (PLUS Study).

Arthritis Rheum,

Low blood concentration of hydroxychloroquine is a marker for and predictor of disease exacerbations in patients with systemic lupus erythematosus.

Lupus,

Hydroxychloroquine use predicts complete renal remission within 12 months among patients treated with mycophenolate mofetil therapy for membranous lupus nephritis.

Arthritis Rheumatol, 2020 Jan 07

Hydroxychloroquine Blood Levels Predict Hydroxychloroquine Retinopathy.

Lupus Sci Med, 2019

Low hydroxychloroquine blood levels in patients who have had gastric bypass surgery.

Best practice & research. Clinical rheumatology, 2013-06

Cutaneous lupus erythematosus: diagnosis and treatment.

Dermatol Ther, 2016 Apr 12

Review of treatment for discoid lupus erythematosus.

Am J Clin Dermatol,

Bullous systemic lupus erythematosus: a review and update to diagnosis and treatment.

Journal of the American Academy of Dermatology, 2011-05

Quality of life in cutaneous lupus erythematosus.

Lupus, 2016 May 27

Cutaneous lupus erythematosus and systemic lupus erythematosus are associated with clinically significant cardiovascular risk: a Danish nationwide cohort study.

Clin Exp Rheumatol, 2013 Aug 02

Pain and pruritus in cutaneous lupus: their association with dermatologic quality of life and disease activity.

J Rheumatol, 2022 Aug 01

Timing and Predictors of Incident Cardiovascular Disease in Systemic Lupus Erythematosus: Risk Occurs Early and Highlights Racial Disparities.

Arthritis Care Res (Hoboken), 2022 Aug 04

Impact of Belimumab on Organ Damage in Systemic Lupus Erythematosus.

JAMA dermatology, 2018-10-01

Association Between Autoantibody Phenotype and Cutaneous Adverse Reactions to Hydroxychloroquine in Dermatomyositis.

,

Systemic Treatment for Clinically Amyopathic Dermatomyositis at 4 Tertiary Care Centers.

Archives of dermatology, 2002 Sep

Adverse cutaneous reactions to hydroxychloroquine are more common in patients with dermatomyositis than in patients with cutaneous lupus erythematosus.

Ann Afr Med, 2020 Jul-Sep

Refractory lupus panniculitis treated successfully with rituximab: Two cases.

Arch Dermatol, 2006 Mar

Lupus erythematosus profundus successfully treated with dapsone: review of the literature.

Clin Rev Allergy Immunol, 2010 Apr

Intravenous immunoglobulin in lupus panniculitis.

Lupus, 2020 Mar 19

Successful treatment of refractory lupus erythematosus profundus with the interleukin-6 antagonist tocilizumab: a case report.

Clinical and experimental dermatology, 2021 Mar 09

Brodalumab-induced subacute cutaneous lupus erythematosus.

JAAD case reports, 2019 Mar 01

Ustekinumab-induced subacute cutaneous lupus.

Dermatologic therapy, 2020 May 03

Secukinumab-induced subacute cutaneous lupus erythematosus.

Lupus, 2019-05

Photosensitivity and photoprotection in patients with lupus erythematosus.

Journal of the American Academy of Dermatology, 2020 Apr 28

Cosmetic treatment in patients with autoimmune connective tissue diseases: Best practices for patients with lupus erythematosus.

The British journal of dermatology, 2003 Jul

Photosensitivity in patients with lupus erythematosus: a clinical and photobiological study of 100 patients using a prolonged phototest protocol.

Arthritis care & research, 2016 Jan

Vitamin D Supplementation in Adolescents and Young Adults With Juvenile Systemic Lupus Erythematosus for Improvement in Disease Activity and Fatigue Scores: A Randomized, Double-Blind, Placebo-Controlled Trial.

Lupus, 2014 Feb 06

Vitamin D and cutaneous lupus erythematosus: effect of vitamin D replacement on disease severity.

Annals of the rheumatic diseases, 2023 Oct 12

EULAR recommendations for the management of systemic lupus erythematosus: 2023 update.

Journal of the American Academy of Dermatology, 2015 Jan 30

Influence of smoking on the efficacy of antimalarials in cutaneous lupus: a meta-analysis of the literature.

Journal of the European Academy of Dermatology and Venereology : JEADV, 2016 Dec 20

S2k guideline for treatment of cutaneous lupus erythematosus - guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV).

Arthritis care & research, 2023 Nov 28

Reference Range of Hydroxychloroquine Blood Levels That Can Reduce Odds of Active Lupus and Prevent Flares.

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