Leflunomide in subacute cutaneous lupus erythematosus - two sides of a coin.

BACKGROUND

Subacute cutaneous lupus erythematosus (SCLE), a distinct clinical subset of lupus erythematosus, remains a therapeutic challenge, especially in cases resistant to topical and standard systemic therapy. Leflunomide, a novel antirheumatic drug, has shown efficacy in the treatment of systemic lupus erythematosus in pilot studies.

METHODS

We report two patients with SCLE who demonstrated the spectrum of possible clinical responses to leflunomide therapy.

RESULTS

One patient experienced a complete clinical remission of symptoms, whereas the other developed a massive skin reaction which was distinctly related to the commencement of leflunomide therapy.

CONCLUSION

To our knowledge, this is the first time that remission and deterioration of SCLE by leflunomide therapy have been described.