The Aims Of Therapy:
The goals of treatment are to control and stop the development of new lesions so as to minimize and prevent scarring and disfigurement. In addition, scars can be appropriately managed to minimize their cosmetic impact.
Topical And Local Treatment:
Individual lesions of lupus are best treated by the application of topical corticosteroid medications, either in cream or ointment form. The potency of the corticosteroid used, will vary with the thickness of the lesions and their location. In selected cases, injection of corticosteroids directly into the lesions results in the best improvement.
In the presence of advancing disease despite local therapy or in the presence of widespread disease, systemic therapy is considered.
First line systemic therapy consists of the use of antimalarial drugs. If the skin disease is resistant to a single antimalarial drug, a combination of antimalarial drugs is often used next.
Second line therapy consists of the use of other drugs that have been shown to modulate the immune system such as the vitamin A derivatives (isotretinoin or acitretin) or dapsone.
If these agent fail, more potent immunosuppressive drugs are used on rare occasion. These may include methotrexate, azathioprine, mofetil mycophenolate, cyclosporine, systemic corticosteroids, and thalidomide.
Cosmetics can be used to minimize the impact of established lesions. Camouflage cosmetics such as Covermark can efficiently minimize discoloration.