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Golimumab-exacerbated subacute cutaneous lupus erythematosus.
Arch Dermatol. 2012 Oct; 148(10):1186-90.AD

Abstract

BACKGROUND

Subacute cutaneous lupus erythematosus (SCLE) is characterized by annular, nonscarring, photodistributed, or papulosquamous lesions. The disease may be idiopathic, drug induced, or drug exacerbated.

OBSERVATIONS

A 66-year-old woman with a history of hypertension, parkinsonism, rheumatoid arthritis, anxiety and depression, and symptoms of Sjögren syndrome was seen with a 1-month history of an eruption on her upper extremities and upper trunk. The eruption had begun 2 to 3 weeks after subcutaneous injection of golimumab for rheumatoid arthritis. She had developed SCLE 2 years previously due to furosemide use and 10 years previously due to hydrochlorothiazide use. Physical examination revealed scaly, annular, erythematous plaques photodistributed on the arms, legs, and upper trunk. A punch biopsy specimen demonstrated vacuolar interface dermatitis and lymphohistiocytic perivascular inflammation. Serological abnormalities included a positive antinuclear antibody, an elevated anti-La/SS-B antibody level, and an elevated anti-Ro/SS-A antibody level. She was diagnosed as having SCLE and was initially treated with desonide lotion, photoprotection, prednisone (40 mg/d) tapered over 6 weeks, and hydroxychloroquine sulfate (200 mg twice daily). Because of persistent disease, methotrexate sodium (12.5 mg/wk) was subsequently added to the regimen, and her eruption cleared completely.

CONCLUSIONS

Golimumab should be added to the list of medications capable of inducing or exacerbating SCLE. Our patient demonstrated variable times to the resolution of SCLE, possibly attributable in part to the different half-lives of the agents administered.

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Authors+Show Affiliations

Wilkerson E
Division of Dermatology, University of Louisville, Louisville, KY 40202, USA.
Hazey MA
No affiliation info available
Bahrami S
No affiliation info available
Callen JP
No affiliation info available

MeSH

AgedAnti-Inflammatory AgentsAntibodies, MonoclonalAntirheumatic AgentsChloroquineDesonideDrug EruptionsFemaleHumansLupus Erythematosus, CutaneousMethotrexatePrednisone

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

23069957

Citation

Wilkerson, Eric, et al. "Golimumab-exacerbated Subacute Cutaneous Lupus Erythematosus." Archives of Dermatology, vol. 148, no. 10, 2012, pp. 1186-90.
Wilkerson E, Hazey MA, Bahrami S, et al. Golimumab-exacerbated subacute cutaneous lupus erythematosus. Arch Dermatol. 2012;148(10):1186-90.
Wilkerson, E., Hazey, M. A., Bahrami, S., & Callen, J. P. (2012). Golimumab-exacerbated subacute cutaneous lupus erythematosus. Archives of Dermatology, 148(10), 1186-90. https://doi.org/10.1001/archdermatol.2012.1856
Wilkerson E, et al. Golimumab-exacerbated Subacute Cutaneous Lupus Erythematosus. Arch Dermatol. 2012;148(10):1186-90. PubMed PMID: 23069957.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Golimumab-exacerbated subacute cutaneous lupus erythematosus. AU - Wilkerson,Eric, AU - Hazey,Matthew A, AU - Bahrami,Soon, AU - Callen,Jeffrey P, PY - 2012/10/17/entrez PY - 2012/10/17/pubmed PY - 2013/1/5/medline SP - 1186 EP - 90 JF - Archives of dermatology JO - Arch Dermatol VL - 148 IS - 10 N2 - BACKGROUND: Subacute cutaneous lupus erythematosus (SCLE) is characterized by annular, nonscarring, photodistributed, or papulosquamous lesions. The disease may be idiopathic, drug induced, or drug exacerbated. OBSERVATIONS: A 66-year-old woman with a history of hypertension, parkinsonism, rheumatoid arthritis, anxiety and depression, and symptoms of Sjögren syndrome was seen with a 1-month history of an eruption on her upper extremities and upper trunk. The eruption had begun 2 to 3 weeks after subcutaneous injection of golimumab for rheumatoid arthritis. She had developed SCLE 2 years previously due to furosemide use and 10 years previously due to hydrochlorothiazide use. Physical examination revealed scaly, annular, erythematous plaques photodistributed on the arms, legs, and upper trunk. A punch biopsy specimen demonstrated vacuolar interface dermatitis and lymphohistiocytic perivascular inflammation. Serological abnormalities included a positive antinuclear antibody, an elevated anti-La/SS-B antibody level, and an elevated anti-Ro/SS-A antibody level. She was diagnosed as having SCLE and was initially treated with desonide lotion, photoprotection, prednisone (40 mg/d) tapered over 6 weeks, and hydroxychloroquine sulfate (200 mg twice daily). Because of persistent disease, methotrexate sodium (12.5 mg/wk) was subsequently added to the regimen, and her eruption cleared completely. CONCLUSIONS: Golimumab should be added to the list of medications capable of inducing or exacerbating SCLE. Our patient demonstrated variable times to the resolution of SCLE, possibly attributable in part to the different half-lives of the agents administered. SN - 1538-3652 UR - https://www.unboundmedicine.com/medline/citation/23069957/Golimumab_exacerbated_subacute_cutaneous_lupus_erythematosus_ L2 - https://jamanetwork.com/journals/jamadermatology/fullarticle/10.1001/archdermatol.2012.1856 DB - PRIME DP - Unbound Medicine ER -