Diagnostic approach and treatment of cutaneous lupus erythematosus

Cutaneous lupus erythematosus (CLE) is a heterogeneous disorder with a wide range of skin manifestations. In the second part of this review, diagnostic procedures and treatment options in CLE are summarized.The diagnosis of the various subtypes of CLE is based on patients's history,clinical findings,laboratory features, and histological and immunofluorescent examinations of skin biopsies. In case of systemic organ involvement, further adequate technical investigations are necessary. The therapy has to be adjusted to the subtype of CLE and its inflammatory activity as well as the extent of skin involvement. The skin manifestations of CLE are primarily treated by topical therapy, such as glucocorticosteroids, in combination with antimalarials. The response of CLE to immunosuppressive drugs that control organ involvement in systemic lupus erythematosus is often disappointing. Recent advances in biotechnology resulted in the development of several novel systemic agents for the treatment of autoimmune diseases; however, controlled clinical trials are still necessary for the approval of new therapies in CLE.