Authors: Jerome H Check, Brooke Neumann, Diane L Check.
There are many therapies to treat discoid lupus erythematous (DLE) which provide mild to moderate beneficial effect. However, none of these suggested therapies are ideal, and thus research continues exploring the immunological pathways responsible for DLE hopefully leading to the development of monoclonal antibody therapy to disrupt a key pathway leading to the pathological state. New brand-named drugs are usually associated with a hefty price and frequently there are significant side effects. Thus, ideally it would be very beneficial to re-purpose an inexpensive generic drug already on the market that is effective with little side effects. One such drug for DLE already exists, e.g., the anti-malarial hydroxychloroquine which frequently can be moderately successful. Another potential drug fulfilling these ideals may be a dopaminergic drug, e.g., dextroamphetamine sulfate, normally used for attention- deficit hyperactivity disorder which has been used to successfully treat other skin disorders e.g., urticaria, eczema, and bullous pemphigoid. The hypothesized mechanism involves releasing more dopamine from sympathetic nerve fibers. Dopamine diminishes cellular permeability, thus, theoretically inhibiting absorption of irritating elements into the dermis, which sets off an immune cascade. The case of DLE presented did not respond to standard therapy for DLE, but had a 100% remission with dextroamphetamine sulfate, which has lasted one and a half years so far.
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