[Subacute cutaneous lupus. Evolutive and therapeutic features of a series of 24 cases].

OBJECTIVE: Subacute cutaneous lupus is a clinical entity defined in 1979 by Sontheimer. Anti-malaria drugs are used as standard treatment for flare-ups, but in case of failure, less well-known alternative therapies may be used. The aim of this work was to determine how patients with subacute cutaneous lupus respond to these other treatments. PATIENTS AND METHODS: Twenty-four cases of subacute cutaneous lupus diagnosed between 1980 and 1998 and followed for 5 years (mean, range 3 months to 16 years) were reviewed retrospectively. Anti-malaria drugs were used as first line treatment in 23 cases and thalidomide alone or in combination in 13 cases. RESULTS: Prognosis of subacute cutaneous lupus was good in our series. There was no renal involvement and none of the patients presented neurological involvement of the psychiatric type. Anti-malaria drugs were insufficient in 13 cases. Thalidomide, either alone or in combination, was then used and was successful in 11 out of 13. Tolerance to treatment was good. Treatment withdrawal was required because of adverse effects in 4 out of 24 patients given anti-malaria drugs and in 3 out of 13 given thalidomide. DISCUSSION: Besides the good prognosis of subacute cutaneous lupus, our series emphasizes the important contribution of thalidomide to second line treatment.