Sustained Drug Free Remission of Lupus Panniculitis with Methotrexate: A Case Report From Nepal

  • Binit Vaidya Department of Rheumatology, National Center for Rheumatic Diseases, Kathmandu, Nepal http://orcid.org/0000-0002-4840-8924
  • Rikesh Baral Department of Rheumatology, National Center for Rheumatic Diseases, Kathmandu, Nepal
  • Hritu Baral Department of Rheumatology, National Center for Rheumatic Diseases, Kathmandu, Nepal
  • Shweta Nakarmi Department of Rheumatology, National Center for Rheumatic Diseases, Kathmandu, Nepal
Keywords: lupus; panniculitis; Nepal; Methotrexate

Abstract

Cutaneous manifestations are second most common presenting feature of lupus. Discoid lupus erythematosus is the most common variant amongst all; lupus panniculitis being described in only 2-5% of cases. Most cases of cutaneous lupus are associated with autoantibodies and either precede or follow the systemic manifestations of lupus. There is no proven treatment for cutaneous manifestations of lupus including lupus panniculitis. Available non-randomized studies show efficacy of hydroxychoroquine in most cases, whereas methotrexate and other immunosuppressant are used in relapsing cases.

We describe a case of lupus panniculitis presenting as an isolated manifestation of lupus with negative autoantibody titers which responded well to methotrexate. We observed that lesions went into drug-free remission in 1year and did not recur on 1year follow-up. There was no residual skin atrophy or scarring. Drug-free remission in isolated cases of lupus panniculitis variant could be possible with timely intervention in the absence of autoantibodies

Published
2018-12-31
How to Cite
Vaidya, B., Baral, R., Baral, H., & Nakarmi, S. (2018). Sustained Drug Free Remission of Lupus Panniculitis with Methotrexate: A Case Report From Nepal. Journal of Nepal Medical Association, 56(214), 963-966. https://doi.org/10.31729/jnma.3885
Section
Case Reports