Response to Antimalarial Agents in Cutaneous Lupus Erythematosus

Abstract

Antimalarial drugs have been in use for the treatment of cutaneous lupus erythematosus (CLE) since 1894, when the use of quinine was reported to be beneficial in lupus erythematosus (LE).¹ During World War II, British physicians observed that soldiers with rheumatoid arthritis and systemic lupus erythematosus (SLE) improved while taking quinacrine, a synthetic derivative of quinine.² Following the landmark 1951 article by Page,³ various reports over the next 10 years confirmed the efficacy of antimalarial agents in treating LE.⁴ Antimalarial agents are now considered first-line systemic therapy in CLE.^5,6 Quiz Ref ID Several mechanisms have been proposed to explain the therapeutic benefit of antimalarial agents in CLE: suppression of antigen presentation, inhibition of prostaglandin and cytokine synthesis, lysosomal stabilization, inhibition of toll-like receptor signaling, and photoprotective properties.^7,8