An update in drug-induced subacute cutaneous lupus erythematosus

Abstract

Background: It has been over three decades since the first report of drug-induced subacute cutaneous lupus erythematosus (DI-SCLE) was described. With an increasing variety of implicated drugs and the potential for publication bias, we must consider: 1) has there been a change in drugs most often reported in DI-SCLE over time, and, 2) if so, of which drugs should clinicians be most suspicious in the setting of possible DI-SCLE? Objective: To determine which drug(s) present the highest risk for inducing DI-SCLE. Methods: The PubMed database was queried for reports of DI-SCLE from August, 2009 until May, 2016. Cases reported in the English language were organized by drug class and compared with the results of our previous review. Results: From 55 selected publications, 95 qualified reports of DI-SCLE were identified. With the exception of a population-based study from Sweden, all other reports of DI-SCLE appeared as case reports or small case series. Cases associated with proton pump inhibitors relative to all other medications were increased by 34.1%. Reports associated with antihypertensive and antifungal medications decreased by 28.9% and 22.4%, respectively during this timeframe. The majority of new reports were associated with drugs not previously described. Greater than 70% of reports since August, 2009 were from European countries. Conclusions: The number of drugs associated with DI-SCLE is increasing. However, a form of publication bias has likely contributed to this shift in reporting. There is a need for additional large, population-based studies in this area.