Systemic Lupus Erythematosus - Treatment for Cutaneous and Mild SLE

Highlights	Complications	Lifestyle Changes
Introduction	Diagnosis	Resources
Causes	Treatment	References
Risk Factors	Treatment for Cutaneous and Mild SLE
Symptoms	Treatment for Severe SLE

Treatment for Cutaneous and Mild SLE

Creams. Steroid creams are often used for skin lesions. However, many patients with discoid lupus do not respond to steroids, particularly if they have eruptions that are caused by sun sensitivity. A cream derived from vitamin A (Tegison) has been beneficial for some lesions that do not clear up with steroid creams.

Sun Protection. Sun protection is essential. Patients should always use sunblock creams (not just sunscreens) and always wear hats and clothing made of tightly woven fabrics.

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Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Common NSAIDs. NSAIDs block prostaglandins, the substances that dilate blood vessels and cause inflammation and pain. There are dozens of NSAIDs.

Over-the-counter NSAIDs include aspirin, ibuprofen (Motrin IB, Advil, Nuprin, Rufen), naproxen (Aleve), ketoprofen (Actron, Orudis KT).
Prescription NSAIDs include ibuprofen (Motrin), naproxen (Naprosyn, Anaprox), diclofenac (Voltaren), tolmetin (Tolectin), ketoprofen (Orudis, Oruvail), dexibuprofen (Seractil).

Regular, long-term use of NSAIDs has been associated ulcers and gastrointestinal bleeding. [See Box: NSAID-induced Ulcers and Gastrointestinal bleeding.]

An ulcer is a crater-like lesion on the skin or mucous membrane caused by an inflammatory, infectious, or malignant condition. Patients can take certain medicines to suppress the acid in the stomach causing the the erosion of the stomach lining. Endoscopic therapy can be used to stop bleeding from the ulcer.

NSAIDs may also cause increases in blood pressure. The highest risks have been observed with piroxicam (Feldene), naproxen (Aleve), and indomethacin (Indocin). People with hypertension, severe vascular disease, kidney, or liver problems and those taking diuretics must be closely monitored if they need to take NSAIDs.

Other NSAID said effects can include:

Delayed emptying of the stomach, which could interfere with the actions of other drugs (elderly are at special risk)
Dizziness
Tinnitus (ringing in the ear)
Headache
Skin rash
Confusion or bizarre sensation (in some higher-potency NSAIDs, such as indomethacin)

As with acetaminophen, high daily doses of aspirin have been associated with an increased risk of kidney failure, although the risk remains low in those with healthy kidney function. Kidney abnormalities have been reported in people taking other NSAIDs as well, which resolve when the drugs are withdrawn. Any sudden weight gain or swelling should be reported to a doctor. Anyone with kidney disease should avoid these drugs.