Lupus erythematosus induced by medications, ultraviolet radiation, and other exogenous agents: a review, with special focus on the development of subacute cutaneous lupus erythematosus in a genetically predisposed individual

Int J Dermatol. 2004 Feb;43(2):87-94. doi: 10.1111/j.1365-4632.2004.02013.x.


Exogenous agents implicated in or suspected of precipitating subacute cutaneous lupus erythematosus (SCLE) and lupus erythematosus (LE) are reviewed. An illustrative case of environmentally induced SCLE is presented. A previously healthy 30-year male homozygous for the tumor necrosis factor-alpha (TNF-alpha) 308. A promoter allele developed SCLE after spending several hours removing fertilizer- and pesticide-containing hay from an agricultural barn in the springtime. The cutaneous eruption soon resolved, only to reappear 3 weeks later on the day the patient re-entered the barn. An environmental agent present in the barn, coupled with springtime ultraviolet light, likely triggered the disease in this immunogenetically susceptible individual.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Biopsy, Needle
  • Drug-Related Side Effects and Adverse Reactions
  • Environmental Exposure / adverse effects*
  • Follow-Up Studies
  • Genetic Predisposition to Disease*
  • Humans
  • Immunohistochemistry
  • Insecticides / adverse effects*
  • Lupus Erythematosus, Cutaneous / chemically induced*
  • Lupus Erythematosus, Cutaneous / genetics*
  • Lupus Erythematosus, Cutaneous / pathology
  • Male
  • Risk Assessment
  • Severity of Illness Index
  • Tumor Necrosis Factor-alpha / genetics
  • Ultraviolet Rays / adverse effects


  • Insecticides
  • Tumor Necrosis Factor-alpha