{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T01:48:12Z","timestamp":1777513692525,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2012,11,1]],"date-time":"2012-11-01T00:00:00Z","timestamp":1351728000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Med Surg"],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Hypertrophic lupus is an uncommon clinical variant of chronic cutaneous lupus that remains a challenge to treat. A 45-year-old female day-care worker with long-standing lupus presented with hypertrophic cutaneous involvement on the dorsal hand, elbow, and toe of 6 years' duration. Treatmentsincluded monotherapy with either hydroxychloroquine or chloroquine and potent topical and intralesional steroid injection. Systemic chemotherapy with R\u2013CHOP chemotherapy for stage IIA diffuse large B-cell lymphoma did not clear the skin findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To review the clinical presentation and treatment of hypertrophic lupus. This report documents clinical improvement in refractory hypertrophic lupus with a regimen of acitretin and combination antimalarial therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The available published literature on the treatment of hypertrophic lupus was reviewed. There is limited published experience combining retinoids and antimalarials for the treatment of refractory lupus. Combination therapy with two antimalarials (ie, quinacrine with either hydroxychloroquine or chloroquine) provides therapeutic benefit for resistant cutaneous disease. In this case, triple therapy with two antimalarials and an oral retinoid achieved clinical clearance relatively rapidly, and this effect was maintained over a year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>This article reports successful treatment of refractory hypertrophic discoid lupus with combination therapy that included chloroquine 250 mg\/d, quinacrine 100 mg\/d, and actitretin 25 mg\/d.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This report suggests that combination therapy using two antimalarials and an oral retinoid is a consideration for refractory hypertrophic lupus, but further study is warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Contexte:<\/jats:title>\n                    <jats:p>Le lupus hypertrophique est une variante clinique rare du lupus cutan\u00e9 chronique, une affection difficile \u00e0 traiter. Une travailleuse des services de garderie souffrant de lupus depuis longtemps a consult\u00e9 pour la pr\u00e9sence de l\u00e9sions cutan\u00e9es hypertrophiques sur le dos de la main, le coude et les orteils, et ce, depuis 6 ans. Plusieurs traitements ont \u00e9t\u00e9 tent\u00e9s, notamment l'hydroxychloroquine ou la chloroquine en monoth\u00e9rapie, de puissants m\u00e9dicaments topiques, et des injections intral\u00e9sionnelles de st\u00e9ro\u00efde; la chimioth\u00e9rapie R-CHOP par voie g\u00e9n\u00e9rale, pour les lymphomes diffus, \u00e0 grandes cellules B, de stade IIA, n'est pas venu \u00e0 bout des l\u00e9sions cutan\u00e9es.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectif:<\/jats:title>\n                    <jats:p>L'\u00e9tude avait pour objectif de passer en revue le tableau clinique et le traitement du lupus hypertrophique. Le pr\u00e9sent rapport fait \u00e9tat d'une att\u00e9nuation clinique du lupus hypertrophique r\u00e9fractaire, par un traitement compos\u00e9 d'acitr\u00e9tine et d'une association d'antipaludiques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>M\u00e9thode:<\/jats:title>\n                    <jats:p>Nous avons pass\u00e9 en revue la documentation publi\u00e9e, accessible sur le traitement du lupus hypertrophique. Les rapports publi\u00e9s d'exp\u00e9riences associant les r\u00e9tino\u00efdes et les antipaludiques dans le traitement du lupus r\u00e9fractaire \u00e9taient peu nombreux. L'association de deux antipaludiques, soit la quinacrine avec l'hydroxychloroquine ou la chloroquine, procure un soulagement th\u00e9rapeutique dans les cas de maladie cutan\u00e9e rebelle. Dans le pr\u00e9sent cas, la trith\u00e9rapie, compos\u00e9e de deux antipaludiques et d'un r\u00e9tino\u00efde oral, a produit, dans un temps relativement court, la disparition clinique des l\u00e9sions, et l'effet s'est maintenu sur une p\u00e9riode de 1 an.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>R\u00e9sultats:<\/jats:title>\n                    <jats:p>Le pr\u00e9sent rapport fait \u00e9tat du traitement r\u00e9ussi du lupus disco\u00efde hypertrophique r\u00e9fractaire, compos\u00e9 de chloroquine, 250 mg\/j; de quinacrine, 100 mg\/j, et d'acitr\u00e9tine, 25 mg\/j.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>D'apr\u00e8s le rapport, le traitement d'association, compos\u00e9 de deux antipaludiques et d'un r\u00e9tino\u00efde oral, peut \u00eatre envisag\u00e9 dans le lupus hypertrophique r\u00e9fractaire, mais une \u00e9tude approfondie s'impose.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/120347541201600620","type":"journal-article","created":{"date-parts":[[2017,1,15]],"date-time":"2017-01-15T08:24:48Z","timestamp":1484468688000},"page":"453-457","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Hypertrophic and Ulcerated Discoid Lupus Erythematosus"],"prefix":"10.1177","volume":"16","author":[{"given":"Peter J.","family":"Green","sequence":"first","affiliation":[{"name":"Division of Dermatology, Department of Medicine, and the Division of Anatomic Pathology, Dalhousie University, Halifax, NS."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvia","family":"Pasternak","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, and the Division of Anatomic Pathology, Dalhousie University, Halifax, NS."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2012,11,1]]},"reference":[{"key":"bibr1-120347541201600620","unstructured":"SpannCR, CallenJP, KleinJB, KulickKB. Clinical, serologic and immunogenetic studies in patients with chronic cutaneous (discoid) lupus erythematosus who have verrucous and\/or hypertrophic skin lesions. J Rheumatol 1988;15:256\u201361."},{"key":"bibr2-120347541201600620","doi-asserted-by":"crossref","unstructured":"PerniciaroC, RandleH, PerryH. Hypertrophic discoid lupus erythematosus resembling squamous cell carcinoma. 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