Discoid lupus erythematosus. Is systemic treatment necessary?

An evaluation of fluocinolone acetonide applied topically in the treatment of discoid lupus erythematosus is presented. Bilateral comparison of 0.025% fluocinolone acetonide cream to the cream base alone demonstrated the effectiveness of this program. In 59 patients an attempt was made to control this disease with topical fluocinolone acetonide as their only treatment. Forty three patients could be controlled in this fashion. Eleven patients responded partially, but for optimal response required a systemic supplement. Five patients did not show any improvement following topical fluocinolone acetonide applications. Noteworthy, is a group of 37 patients followed through two summer seasons. Twenty-four of these patients could be controlled with topical applications but reapplication the following summer was required. Three patients in this group cleared and remained clear. Six patients followed through two summers required a systemic supplement, while four in this group did not respond to therapy.