When are topical corticosteroids recommended for cutaneous lupus?

Cutaneous lupus can cause persistent plaques, scaling, pigment change, sensitivity to light and, in some forms, scarring or hair loss. A topical corticosteroid can reduce inflammation in a defined lesion, but it does not treat every form of lupus or replace assessment for activity elsewhere in the body. Product strength and location matter: repeated use on the face, scalp or other thin skin needs supervision.

Use the prescribed amount and schedule, and do not extend treatment because a mark remains after inflammation has eased. Protect affected skin from sunlight with shade, protective clothing and the sun protection plan recommended by your clinician. Keep a record of new lesions, changes in colour, tenderness, scaling or scarring. A dermatologist may combine topical treatment with another medicine when lesions are extensive, active or recurring.

Contact your clinician promptly if lesions are rapidly changing, ulcerated, infected-looking, painful or leaving new scars. Seek urgent care for breathing trouble, chest pain, severe weakness, new confusion or rapidly spreading blistering. New mouth, eye or genital symptoms also deserve prompt assessment because topical cream alone may not be appropriate.

Ask whether the lesion needs a biopsy or another test, which strength is appropriate, and how to protect the treated area from sunlight. Discuss signs that could suggest systemic lupus activity and whether your current medicines need review.