30th July 2026

Drug induced chronic cutaneous lupus erythematosus (CCLE)

Associated drugs

• Fluorouracil 
• TNF inhibitors 
• Non-steroidal anti-inflammatory drugs
• Tumour necrosis factor antagonists: infliximab, etanercept
• Voriconazole 

Clinical manifestations

CCLE is extremely rare, with an average incubation period reported of around 8 months after exposure to the culprit medication. The mean age of onset is the 6th decade of life. Most commonly CCLE presents similarly to discoid lupus, however, other presentations can occur: Lupus erythematosus timidus, lupus profundus, chilblain lupus erythematosus and Lichenoid cutaneous lupus erythematosus-lichen planus overlap syndrome. 

Discoid lupus presents as red patches which evolve to form red scaly plaques. The rash progresses, leading to atrophic scarring with hyper or hypopigmentation. It most commonly occurs on the face or the ear lobes.