Intravenous immunoglobulin in lupus panniculitis.

Area of Science:

• Dermatology
• Rheumatology
• Immunology

Background:

• Systemic lupus erythematosus (SLE) is a complex autoimmune disease with diverse systemic and cutaneous manifestations.
• Cutaneous lupus erythematosus (CLE) encompasses various skin conditions, including lupus erythematosus panniculitis (LEP), a rare subtype.
• LEP presents as recurrent nodular or plaque lesions, ranging from mild to disfiguring.

Observation:

• Standard treatments for LEP include corticosteroids, antimalarials, and azathioprine.
• Refractory cases may be managed with combination antimalarials, mycophenolate mofetil, or other immunomodulators.
• Intravenous immunoglobulin (IVIG) is utilized in various autoimmune conditions, but its efficacy in LEP lacks robust clinical trial data.

Findings:

• This report reviews SLE skin manifestations and treatment options.
• A case of LEP successfully treated with IVIG is presented.
• IVIG was effective in a patient with refractory LEP where conventional therapies were insufficient.

Implications:

• Intravenous immunoglobulin (IVIG) may represent a viable therapeutic option for recalcitrant cases of lupus erythematosus panniculitis (LEP).
• Further clinical trials are warranted to establish the efficacy and safety of IVIG for LEP.
• This case highlights the potential of IVIG in managing severe cutaneous lupus manifestations.