SCLE

Subacute Cutaneous LE (SCLE):

• Lesions involve the epidermis and upper dermis.

• Most patients exhibit or report photosensitivity and have anti-SSA/Ro autoantibodies.

• Presents with annular or papulosquamous lesions.

• Lesions may be photodistributed and can be widespread.

• Usually no serious systemic involvement, but some patients may have features of Sjögren syndrome.

• Drug-induced SCLE should be considered in adults - about one third of patients that present with SCLE are drug induced exacerbation of previously well-controlled disease

• Drugs most commonly associated:

  • Hydrochlorothiazide

  • Terbinafine

  • TNF inhibitors

  • anti-epileptics

  • PPI

  • immune check-point inhibitors: pembrolizumab, Nivolumab also linked

• stopping offending medication doesn’t always lead to clearance