Lansoprazole-induced subacute cutaneous lupus erythematosus.

©2017 Turkish League Against Rheumatism. All rights reserved. A 23-year-old female patient presented with a one-week history of itchy skin lesions distributed on the upper chest, extensor sides of the arms, and the trunk. Two weeks earlier, the patient had been prescribed lansoprazole 40 mg/day due to the symptoms of gastroesophageal reflux. Physical examination revealed multiple erythematous, annular plaques of varying sizes distributed on the upper chest, arms and trunk (Figure 1). In laboratory analysis of the blood, antinuclear antibodies were detected at a titer of 1/160 with a diffuse pattern. Anti-doublestranded deoxyribonucleic acid was negative and anti-Ro/Sjögren's syndrome A (SSA), anti-La/ Sjögren's syndrome B (SSB) antibodies, and antihistone antibodies were positive. Histopathologic examination of the skin biopsy revealed atrophic epidermis and vacuolar degeneration of the basal layer (Figures 2a, b). Immunofluorescence was weakly positive for C3 at the basement membrane. Depending on the clinical history, autoantibody profile, and the histopathologic findings, the patient was diagnosed as having lansoprazole-induced subacute cutaneous lupus erythematosus (SCLE). The lansoprazole therapy was discontinued and the patient was given hydroxychloroquine sulfate 200 mg/day. At the follow-up, all lesions disappeared after one month. Hydroxychloroquine sulfate therapy was stopped after three months and it was observed that no lesions occurred during one-year follow-up. A written informed consent was obtained from the patient.