Leflunomide in subacute cutaneous lupus erythematosus - two sides of a coin

Int J Dermatol. 2008 Jan;47(1):83-6. doi: 10.1111/j.1365-4632.2007.03333.x.


Background: Subacute cutaneous lupus erythematosus (SCLE), a distinct clinical subset of lupus erythematosus, remains a therapeutic challenge, especially in cases resistant to topical and standard systemic therapy. Leflunomide, a novel antirheumatic drug, has shown efficacy in the treatment of systemic lupus erythematosus in pilot studies.

Methods: We report two patients with SCLE who demonstrated the spectrum of possible clinical responses to leflunomide therapy.

Results: One patient experienced a complete clinical remission of symptoms, whereas the other developed a massive skin reaction which was distinctly related to the commencement of leflunomide therapy.

Conclusion: To our knowledge, this is the first time that remission and deterioration of SCLE by leflunomide therapy have been described.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Antirheumatic Agents / administration & dosage*
  • Antirheumatic Agents / adverse effects
  • Diagnosis, Differential
  • Drug Eruptions / diagnosis
  • Drug Eruptions / etiology*
  • Enzyme Inhibitors / administration & dosage*
  • Enzyme Inhibitors / adverse effects
  • Erythema Multiforme / chemically induced*
  • Erythema Multiforme / diagnosis
  • Female
  • Fluorescent Antibody Technique, Direct
  • Humans
  • Isoxazoles / administration & dosage*
  • Isoxazoles / adverse effects
  • Leflunomide
  • Lupus Erythematosus, Cutaneous / chemically induced*
  • Lupus Erythematosus, Cutaneous / diagnosis
  • Lupus Erythematosus, Cutaneous / drug therapy*
  • Male
  • Skin / pathology


  • Antirheumatic Agents
  • Enzyme Inhibitors
  • Isoxazoles
  • Leflunomide