皮肤型红斑狼疮的治疗现状

Management of Cutaneous Lupus Erythematosus

皮肤型红斑狼疮是红斑狼疮病谱中相对较轻的一型,治疗上有别于系统性红斑狼疮,目前尚无固定的治疗模式。局部外用糖皮质激素是广泛采用的治疗手段之一,对各种皮肤型红斑狼疮均有效。较新型的外用制剂如他克莫司及吡美莫司,主要用于治疗对糖皮质激素和常规药物无效的皮肤型红斑狼疮。对外用药物治疗无效的皮损,可选择皮损内注射糖皮质激素,以快速发挥抗炎和免疫抑制作用。细胞毒药物和沙利度胺主要治疗复发或难治性皮肤型红斑狼疮。激光及光疗也能有效改善皮肤型红斑狼疮的皮损。

Cutaneous lupus erythematosus is a relatively mild subtype in the spectrum of lupus erythematosus. The management of cutaneous lupus erythematosus is different from that of systemic lupus erythematosus （SLE）. Topical therapies are usually useful in the treatment of cutaneous lupus erythematosus. When lesions are not controlled with topical corticosteroids, intralesional corticosteroids are often indicated. Antimalarial, corticosteroid, retinoids are mainstays in systemic therapy, and cytotoxic agents and thalidomide are effective for patients who are resistant to routine therapies. Pulsed dye laser and ultraviolet therapy can be helpful in the treatment of cutaneous lupus erythematosus.