Successful Treatment with Hydroxychloroquine for Systemic Lupus Erythematosus with Cutaneous Involvement Accompanied by a Xanthomatous Reaction

A 34-year-old woman with systemic lupus erythematosus (SLE) and cutaneous involvement, including alopecia and a xanthomatous reaction, was successfully treated with hydroxychloroquine (HCQ). Despite initial treatment with prednisolone (PSL), her hair loss persisted. Pathological examination revealed characteristic lupus erythematosus changes and xanthomatous cell infiltration. After starting HCQ at 200 mg/day, her skin lesions resolved within five months without increasing the PSL dose. This case highlighted the potential of HCQ in treating refractory cutaneous lupus erythematosus and suggested that chronic epithelial injury in discoid lupus erythematosus (DLE) might trigger secondary xanthomatous reactions.