Resistant discoid lupus erythematosus of palms and soles: successful treatment with azathioprine

J Am Acad Dermatol. 1988 Nov;19(5 Pt 2):961-5. doi: 10.1016/s0190-9622(88)70259-5.


We present the case of two patients with an unusual form of discoid lupus erythematosus that was confined almost exclusively to the palms and soles. In both patients this form of discoid lupus erythematosus did not respond to conventional therapies, which included topical steroids, intralesional steroids, prednisone, quinacrine hydrochloride, hydroxychloroquine sulfate, colchicine, and dapsone. Both patients were then treated with azathioprine. One patient dramatically improved with azathioprine, worsened each time the azathioprine was stopped or reduced, and responded again to the reinstitution of therapy. The other patient began taking azathioprine 8 months ago and has also experienced relief of her symptoms. These cases suggest that discoid lupus erythematosus principally involving the palms and soles is difficult to treat with conventional medication and that azathioprine, which appears to be useful, should be tried after the failure of other therapies.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Azathioprine / adverse effects
  • Azathioprine / therapeutic use*
  • Carcinoma, Squamous Cell / ethnology
  • Carcinoma, Squamous Cell / etiology
  • Drug Resistance
  • Female
  • Foot Dermatoses / drug therapy*
  • Hand Dermatoses / drug therapy*
  • Humans
  • Lupus Erythematosus, Discoid / complications
  • Lupus Erythematosus, Discoid / drug therapy*
  • Skin Neoplasms / ethnology
  • Skin Neoplasms / etiology


  • Azathioprine