Diagnostik und Therapie des kutanen Lupus erythematodes – Aktuelles aus der S2k-Leitlinie

 

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Zusammenfassung

Das Therapiemanagement des CLE richtet sich nach der Ausbreitung und dem Schweregrad der Manifestation(en) einschließlich präventiver Maßnahmen (Lichtschutz). Bei ausgedehnten bzw. Läsionen, die nicht ausreichend auf topische Kortikosteroide ansprechen, sollte frühzeitig eine Systemtherapie mit Hydroxychloroquin eingeleitet werden. Sollte diese Therapie nicht ausreichend wirksam sein, können weitere Medikamente, wie MTX oder Acitretin in das Management aufgenommen werden. Bei sehr schweren Verläufen können intravenöse Immunglobuline aber auch neue Biologika, wie Belimumab zum Einsatz kommen. Ein Übergang eines CLE in einen SLE ist bei einem nicht geringen Anteil der Patienten möglich und sollte im Verlauf auch unter Einbezug von paraklinischen Befunden berücksichtigt werden.

Abstract

The management of CLE depends on the localisation and severity of the manifestation(s) and includes preventive measures (photoprotection). Systemic therapy with hydroxychloroquine should be initiated early for extensive lesions or lesions that do not respond adequately to topical corticosteroids. If this therapy is not sufficiently effective, other drugs such as MTX or acitretin can be included into the management. For the most severe cases, intravenous immunoglobulins can be used, as can new biologics such as belimumab. A transition from CLE to SLE is possible in a significant proportion of patients and should be taken into account over the course of the disease, including paraclinical findings.

Publication History

Article published online:
25 May 2022

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