What is your approach to ongoing assessment and medication tapering in well controlled discoid lupus without systemic features?

As with many systemic lupus (SLE) complications, the patient with discoid lupus (DLE) is often best managed by a rheumatologist in tandem with a specialist of that complication, in this case, a good medical dermatologist experienced with cutaneous lupus. Although I think I am good at telling most ac...

If no clinical signs of disease activity (erythema, scale) for at least 6 months I would consider tapering therapy. If stable with topical therapy alone, would taper frequency of application to a few times weekly before discontinuation. If on systemic therapy and no new lesions or signs of clinical ...

Agreed! I also like to use 6 months of inactivity as the time to determine whether to taper.

One other thing I sometimes do is step down the potency of the topical steroid if in remission or use tacrolimus instead to prevent flare ups, especially while tapering off of systemic therapy.