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Cutaneous lupus erythematosus (LE) -- including subacute cutaneous LE (SCLE) and chronic cutaneous LE manifesting as discoid lesions (DLE) -- is managed most often with preventive sun protection, topical corticosteroids, and oral antimalarial agents. Unfortunately, many patients don't respond to these agents or develop toxic reactions to them, and their disease is often termed “recalcitrant.” Alternative therapies for such patients include retinoids, thalidomide, and azathioprine; methotrexate has been reported to be of benefit in single-case observations and small case series.
These investigators retrospectively compared the activity of cutaneous LE at baseline and after 2 to 3 months of low-dose methotrexate therapy in 43 patients. Sixteen…