Table 1.

Different Drugs Used in the Treatment of Discoid Lupus Erythematosus

Name of DrugDoseAdverse EffectsRemarks
Topical and intralesional steroidsStart with potent topical preparation, strength of intradermal triamcinolone 3 to 5 mg/mLCutaneous atrophy, telengiectasiae, striae, and purpura with topical steroids; atrophy and dyspigmentation with intralesional steroidsSide effects from systemic absorption insignificant with topical steroids but can occur with intralesional steroids
AntimalarialsStart with 200 mg per day, no more than 6.5 mg/kg/day to be administeredGastrointestinal upset, ocular toxicity, pruritus, drug eruptions, leucopenia, thrombocytopenia, haemolysisOcular toxicity more marked with chloroquine
Topical tacrolimus0.1% topical ointmentBurning, irritation of skin, pruritusContraindication- infections
ThalidomideInitial dose of 100 to 200 mg/day, usual maintenance dose of 50 to 100 mg/dayTeratogenicity, polyneuropathy, drowsiness, nausea, skin eruptions, dryness of mouth and skin, oedemaPolyneuropathy uncommon with use of low doses
AzathioprineUsual starting dose of 50 to 100 mg/day, usual maintenance dose of 25 to 50 mg/dayMyelosuppression, nausea, infections pancreatitis, rarely hepatotoxicitySerum thiopurine methyltransferase should be measured
CyclosporinInitial dose of 4 to 5 mg/kg/day, which can be reduced with improvementHypertension, nephrotoxicity, hyperlipidemia, hypomagnesemia, gingival hyperplasia, headache, tremor, paresthesia, hypertrichosis, malignancyContraindications include uncontrolled hypertension, uncontrolled infections, and malignancy
Mycophenolate mofetilUsual dose of 1 g twice a dayGastric upset, headache, tremor, hypersensitivity, anemia, leucopenia and thrombocytopenia, infections, neoplasiaFull blood counts should be checked regularly
Methotrexate5 to 15 mg once a week followed by initial test dose of 2.5 mgGastrointestinal upset, myelosuppression, liver toxicity, pulmonary fibrosisMonitor full blood count, liver function tests, and renal function
Acitretin0.5 to 1 mg/kg/dayTeratogenicity, hyperlipidemia, dryness of skin, mucous membranes, taste disturbances, hair lossMonitor full blood count, liver function tests, fasting lipids