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Treatment of chronic discoid lupus erythematosus with an oral gold preparation
Author(s) -
Dalziel K.,
Going S.,
Cartwright P.H.,
Marks R.,
Beveridge G.W.,
Rowell N.R.
Publication year - 1985
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/j.1365-2133.1985.tb12983.x
Subject(s) - medicine , auranofin , dermatology , rash , surgery , discoid lupus erythematosus , lupus erythematosus , stomatitis , rheumatoid arthritis , gastroenterology , antibody , immunology
There are a number of patients who require systemic treatment for discoid lupus erythematosus (DLE), but in whom anti‐malarial drugs are either contra‐indicated or ineffective. A novel gold preparation (‘Auranofin’, Smith, Kline & French) used previously in the treatment of rheumatoid arthritis, has now been assessed in a group of such patients in a multicentre study. Twenty‐two patients with biopsy, proven DLE were included. Patients with any serious concurrent disease or with abnormal haematological or biochemical investigations were excluded. Patients received 6–9 mg of Auranofin daily for up to i year. The commonest side‐effect was diarrhoea which was usually mild and settled without stopping treatment. Other side‐effects included a transient macular rash, pruritus and aphthous stomatitis. Three patients were withdrawn; one with raised alkaline phosphatase levels, one with proteinuria and one with intense pruritus of the scalp in areas affected by DLE. Of the 19 remaining patients, I2 showed a marked improvement with resolution of some or all lesions with several patients experiencing dramatic relief after many years of disease activity. Five patients showed a definite, but less marked, improvement. In general maximum improvement occurred during the early months of treatment. Lesions on the face and upper trunk responded most; thickened warty lesions on the limbs responded least. We feel that oral gold offers a useful alternative treatment for a small group of patients with DLE who can be carefully monitored.