What therapies do you use in patients with cutaneous lupus recalcitrant to topical steroids?

I agree with Dr. @Dr. First Last. In addition, strict photoprotection is absolutely key to clearing up cutaneous lupus of any severity.

I also typically consider (and find to be helpful) mycophenolate mofetil if the patient is not responsive to first-line treatment (hydroxychloroquine).

While useful...

Beyond topical steroids it depends on the subtype of CLE that they have but generally can consider:

ILK, HCQ +/- quinacrine, chloroquine, MTX, dapsone, acitretin, or a JAKi (Baricitinib and tofa with some evidence). Last line could be lenalidomide, IVIG or Ritux but would send to a specialized cente...