PMID- 37101279
OWN - NLM
STAT- MEDLINE
DCOM- 20230428
LR  - 20230429
IS  - 1471-2377 (Electronic)
IS  - 1471-2377 (Linking)
VI  - 23
IP  - 1
DP  - 2023 Apr 26
TI  - Subacute cutaneous lupus erythematosus as a rare complication of 
      disease-modifying therapy administration in multiple sclerosis: case report.
PG  - 168
LID - 10.1186/s12883-023-03146-1 [doi]
LID - 168
AB  - 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 treatment-related 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.
CI  - (c) 2023. The Author(s).
FAU - Xu, Ke
AU  - Xu K
AD  - Department of Neurology, The First Affiliated Hospital of Chongqing Medical 
      University, Chongqing, China.
AD  - National Health Commission Key Laboratory of Diagnosis and Treatment On Brain 
      Functional Diseases, The First Affiliated Hospital of Chongqing Medical 
      University, Chongqing, China.
FAU - Zhang, Mengjie
AU  - Zhang M
AD  - Department of Neurology, The First Affiliated Hospital of Chongqing Medical 
      University, Chongqing, China.
FAU - Yang, Shilin
AU  - Yang S
AD  - Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
FAU - Yu, Gang
AU  - Yu G
AD  - Department of Neurology, The First Affiliated Hospital of Chongqing Medical 
      University, Chongqing, China.
FAU - Zheng, Peng
AU  - Zheng P
AD  - Department of Neurology, The First Affiliated Hospital of Chongqing Medical 
      University, Chongqing, China.
AD  - National Health Commission Key Laboratory of Diagnosis and Treatment On Brain 
      Functional Diseases, The First Affiliated Hospital of Chongqing Medical 
      University, Chongqing, China.
FAU - Qin, Xinyue
AU  - Qin X
AD  - Department of Neurology, The First Affiliated Hospital of Chongqing Medical 
      University, Chongqing, China. qinxinyuecqchina@hotmail.com.
FAU - Feng, Jinzhou
AU  - Feng J
AUID- ORCID: 0000-0003-4987-6313
AD  - Department of Neurology, The First Affiliated Hospital of Chongqing Medical 
      University, Chongqing, China. fengjinzhou@hotmail.com.
LA  - eng
GR  - 81701191/National Natural Science Foundation of China/
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20230426
PL  - England
TA  - BMC Neurol
JT  - BMC neurology
JID - 100968555
RN  - 1C058IKG3B (teriflunomide)
RN  - 4QWG6N8QKH (Hydroxychloroquine)
RN  - G162GK9U4W (Leflunomide)
SB  - IM
MH  - Humans
MH  - Female
MH  - Adult
MH  - Hydroxychloroquine/adverse effects
MH  - *Multiple Sclerosis/complications/drug therapy
MH  - Leflunomide/adverse effects
MH  - *Lupus Erythematosus, Cutaneous/chemically induced/diagnosis/drug therapy
PMC - PMC10131458
OTO - NOTNLM
OT  - Autoimmune diathesis
OT  - Case report
OT  - Leflunomide
OT  - Multiple sclerosis
OT  - Subacute cutaneous lupus erythematosus
OT  - Teriflunomide
COIS- The authors declare that they have no competing interests.
EDAT- 2023/04/27 00:42
MHDA- 2023/04/28 06:41
PMCR- 2023/04/26
CRDT- 2023/04/26 23:44
PHST- 2022/09/20 00:00 [received]
PHST- 2023/02/27 00:00 [accepted]
PHST- 2023/04/28 06:41 [medline]
PHST- 2023/04/27 00:42 [pubmed]
PHST- 2023/04/26 23:44 [entrez]
PHST- 2023/04/26 00:00 [pmc-release]
AID - 10.1186/s12883-023-03146-1 [pii]
AID - 3146 [pii]
AID - 10.1186/s12883-023-03146-1 [doi]
PST - epublish
SO  - BMC Neurol. 2023 Apr 26;23(1):168. doi: 10.1186/s12883-023-03146-1.