Pulse cyclophosphamide treatment for severe refractory cutaneous lupus erythematosus

Cutaneous lupus erythematosus includes a variety of lupus erythematosus specific skin lesions that, in some cases, can be disfiguring and refractory to conventional therapy. This short report describes our experience in treating six patients with severe, refractory subacute cutaneous lupus erythematosus with monthly cyclophosphamide pulses, followed by azathioprine as maintenance therapy. Significant clinical improvement of the subacute cutaneous lupus erythematosus lesions was achieved in all patients, with four patients in complete remission and two in partial remission. Mean time to clinical response was 4.33 +/- 1.36 months. Minor adverse events and no relapses were noted in a follow-up period of more than 3 years. Lupus (2010) 19, 744-747.