Subacute cutaneous lupus erythematosus as a rare complication of disease-modifying therapy administration in multiple sclerosis: case report

作者全名："Xu, Ke; Zhang, Mengjie; Yang, Shilin; Yu, Gang; Zheng, Peng; Qin, Xinyue; Feng, Jinzhou"

作者地址："[Xu, Ke; Zhang, Mengjie; Yu, Gang; Zheng, Peng; Qin, Xinyue; Feng, Jinzhou] Chongqing Med Univ, Affiliated Hosp 1, Dept Neurol, Chongqing, Peoples R China; [Xu, Ke; Zheng, Peng] Chongqing Med Univ, Affiliated Hosp 1, Natl Hlth Commiss Key Lab Diag & Treatment Brain, Chongqing, Peoples R China; [Yang, Shilin] Fudan Univ, Huashan Hosp, Dept Neurol, Shanghai, Peoples R China"

通信作者："Qin, XY; Feng, JZ (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Neurol, Chongqing, Peoples R China."

来源：BMC NEUROLOGY

ESI学科分类：NEUROSCIENCE & BEHAVIOR

WOS号：WOS:000975534200002

JCR分区：Q3

影响因子：2.2

年份：2023

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Multiple sclerosis; Subacute cutaneous lupus erythematosus; Teriflunomide; Leflunomide; Autoimmune diathesis; Case report

摘要："Background Teriflunomide, the active metabolite of leflunomide, is a disease-modifying therapy drug used for the treatment of multiple sclerosis (MS), yet the complications associated with this drug remain not fully understood. Here we present the rare case of a 28-year-old female MS patient who developed subacute cutaneous lupus erythematosus (SCLE) following teriflunomide treatment. Though SCLE has been reported to be associated with leflunomide, the current report represents the first documented evidence demonstrating SCLE as a potential teriflunomide treatmentrelated complication. Additionally, a literature review on the leflunomide-induced SCLE was conducted to emphasize the association of SCLE with teriflunomide, specifically amongst the female demographic with a preexisting autoimmune diathesis. Case presentation A 28-year- old female first presented with MS symptoms in the left upper limb along with blurred vision in the left eye. Medical and family histories were unremarkable. The patient exhibited positive serum biomarkers including ANA, Ro/SSA, La/SSB, and Ro-52 antibodies. Relapsing-remitting MS was diagnosed according to the 2017 McDonald's diagnostic criteria, and remission was achieved upon intravenous administration of methylprednisolone followed by teriflunomide sequential therapy. Three months post-teriflunomide treatment, the patient developed multiple facial cutaneous lesions. SCLE was subsequently diagnosed and was attributed to treatment-related complication. Interventions include oral administration of hydroxychloroquine and tofacitinib citrate effectively resolved cutaneous lesions. Discontinuation of hydroxychloroquine and tofacitinib citrate treatment led to recurring SCLE symptoms under continuous teriflunomide treatment. Full remission of facial annular plaques was achieved after re-treatment with hydroxychloroquine and tofacitinib citrate. The patient's clinical condition remained stable in long-term outpatient follow-ups. Conclusions As teriflunomide has become a standard disease-modifying therapy for MS, the current case report highlights the importance of monitoring treatment-related complications, specifically in relation to SCLE symptoms."

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