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Impressive resolution of refractory hypertrophic discoid lupus erythematosus with anifrolumab
  1. Anthony Ocon1,2,
  2. Eduardo Avalos Sugastti3 and
  3. Nananamibia Duffy4
  1. 1 Rheumatology, Rochester Regional Health, Rochester, New York, USA
  2. 2 Rheumatology, URMC, Rochester, New York, USA
  3. 3 Internal Medicine, Rochester Regional Health, Rochester, New York, USA
  4. 4 Dermatology, Rochester Regional Health, Rochester, New York, USA
  1. Correspondence to Dr Anthony Ocon; anthony.ocon{at}


Hypertrophic discoid lupus erythematosus is a rare variant of chronic cutaneous lupus erythematosus and is often challenging to treat. A male in his early 60s presented with diffuse erythematous, crusty, pruritic plaques on his upper and lower extremities, face, upper back, dorsal aspect of the hands and chest. He also described prolonged morning stiffness, swelling of his fingers and wrists, oral sores and Raynaud’s phenomenon. He was positive for antinuclear antibody and anti-SSA antibody and had low C3 and C4 proteins. The skin biopsy was consistent with hypertrophic discoid lupus erythematosus. He was diagnosed with systemic lupus erythematosus. Skin lesions were refractory to treatment with topical corticosteroids, topical acitretin, hydroxychloroquine, azathioprine or mycophenolate. Anifrolumab infusions were initiated with a near-complete resolution of cutaneous symptoms within 3 months.

  • dermatology
  • connective tissue disease
  • rheumatology
  • systemic lupus erythematosus

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: EAS, ND and AJO. The following authors gave final approval of the manuscript: EAS, ND and AJO.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.