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Mechanism-Oriented Assessment of Isotretinoin in Chronic or Subacute Cutaneous Lupus Erythematosus
Richard C. Newton, MD;
Joseph L. Jorizzo, MD;
Alvin R. Solomon, Jr, MD;
Ramon L. Sanchez, MD;
Jerry C. Daniels, MD, PhD;
John D. Bell, MD;
Tito Cavallo, MD
Arch Dermatol. 1986;122(2):170-176.
Abstract
Eight of ten patients with chronic or subacute cutaneous lupus erythematosus completed 16 weeks of oral isotretinoin therapy (80 mg/day). All eight patients noted an excellent clinical response without significant side effects. (Two patients did not return to initial two-week follow-up.) Peripheral blood B- and T-cell counts were unaffected by therapy. Therapy was associated with resolution of routine histopathologic abnormalities, conversion of abnormal lesional direct immunofluorescence microscopy to normal, normalization of the epidermis on electron microscopy, and reduction of all T cells near the dermoepidermal junction without change in ratio of T-helper/inducer cells to T-suppressor/cytotoxic cells. Isotretinoin is a clinically effective short-term therapy for chronic or possibly for subacute cutaneous lupus erythematosus. The primary mechanism of action remains unestablished.
(Arch Dermatol 1986;122:170-176)
Author Affiliations
From the Departments of Dermatology (Drs Newton, Jorizzo, Solomon, and Sanchez), Pathology (Drs Solomon, Sanchez, and Cavallo), and Internal Medicine (Drs Daniels and Bell), University of Texas Medical Branch, Galveston.
Footnotes
Accepted for publication Aug 20, 1985.
Read before the Joint International Meeting of the Society for Investigative Dermatology and the Japanese Society for Investigative Dermatology, Washington, DC, May 3, 1985.
Reprints not available.
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