Negative findings for anti-extractable nuclear antigen antibodies. Tellingly, she improved after stopping the drug. It occurs in patients differently than systemic lupus erythematosus SLE. A peripheral vasodilator used to treat arterial hypertension since the s, hydralazine is currently being replaced by newer drugs with more acceptable safety profiles.
Clin Exp Dermatol, 27pp.
Chlorpromazine, Hydralazine used to treat high blood pressurePenicillamine, Isoniazid, a-Methyldopa, Procainamide used to treat tachyycardiaSulphasalazine used in colitis, crohn's disease and rheumatoid arthritis. Please note that Internet Explorer version 8. Besides stopping the offending drug, non-steroidal anti-inflammatory drugs NSAIDs may be used to help symptoms resolve faster.
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These abnormalities are less common in idiopathic lupus. Ongoing treatment of at least 1 month with a drug. A systematic review of drug-induced subacute cutaneous lupus erythematosus. Antihistone antibodies in systemic lupus erythematosus.
The medications and other exposures implicated in DILE and flares of SLE produce autoantibodies more often than systemic autoimmune symptoms. The time now is Australas J Dermatol, 46pp.
Eur J Dermatol, 11pp. Drug induced lupus due to anti-tumor necrosis factor alpha agents.
Drug-induced systemic lupus erythematosus after 8 years of treatment with carbamazepine. T cells with hypomethylated DNA become autoreactive and cause antibody formation. Classic DILE is more often associated with antihistone antibodies.
Arthritis is usually symmetric, affects small joints e. Anti-DNA, antihistone, and antinucleosome antibodies in systemic lupus erythematosus and drug-induced lupus.
ANA-positive seroconversion in a patient being treated with a drug that can potentially trigger systemic DILE does not necessarily mean treatment must stop, as only a small percentage of cases progress to lupus. As mentioned above, just as cutaneous and renal involvement are very uncommon in systemic DILE due to hydralazine, pleural and pericardial involvement are especially frequent in cases induced by procainamide. And I know all feared prostate cancer; what man wouldn't?
The clinical spectrum of DILE ranges from circumscribed cutaneous signs to systemic involvement, which is usually mild. Most chronic cases show ANA positivity but anti-extractable nuclear antigen and anti-dsDNA negativity; exceptions are rare. Generally, no other specific treatments are known. In diagnosing this condition, it is extremely crucial to first exclude the possibility that the patient has renal idiopathic lupus rather than DILE with renal involvement.