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Systemic lupus erythematosus is frequently identified by skin rashes. These rashes stem from inflammation as the immune system mistakenly attacks the body’s own tissues.
Systemic lupus erythematosus, often referred to simply as lupus, exhibits a range of symptoms and there is significant potential for improving treatment options.
Cutaneous lupus erythematosus is a prevalent form of systemic lupus erythematosus.
This condition manifests as rashes on various areas, including the face and scalp, along with symptoms like hair loss and skin scarring.
The inflammation causing these rashes is a result of the immune system’s misguided attacks on the body.
The typical approach to treat cutaneous lupus erythematosus involves the use of immunosuppressive and biologic medications to alleviate inflammation.
Although these treatments can be effective, many individuals with systemic lupus erythematosus are already on multiple medications and are seeking alternative treatment options aside from traditional pills.
Dr. J. Michelle Kahlenberg, an internal medicine professor specializing in rheumatology at the University of Michigan Health, spearheaded a team investigating one such alternative: a topical treatment named mupirocin.
This trial was inspired by Kahlenberg’s earlier findings that skin rashes associated with cutaneous lupus are often inhabited by Staphylococcus aureus, a common type of bacteria, which can exacerbate inflammation.
Mupirocin is effective in eliminating this type of bacteria.
The research involved randomly selecting patients with systemic lupus erythematosus who were having flare-ups of cutaneous lupus erythematosus to treat their skin lesions either with mupirocin or an inactive placebo, petrolatum jelly.
Samples from both the nasal area and affected skin were analyzed to assess the levels of Staphylococcus before and after treatment.
Comparative samples taken before treatment and seven days post-treatment exhibited a reduction in Staphylococcus aureus in the mupirocin-treated areas.
Significantly, this decrease in bacteria also coincided with a reduction in inflammatory markers, such as gene expression driven by interferon, in the affected lesions.
“Along with decreasing inflammation by lowering Staphylococcus aureus levels in lesions, mupirocin also reduced skin monocyte levels, which play a critical role in cutaneous lupus pathology,” Kahlenberg explained.
Mupirocin is a medication available by prescription, and while this preliminary study indicated a potential for reducing inflammation, it was not designed to assess the efficacy of mupirocin in eliminating rashes associated with cutaneous lupus erythematosus.
“Further extensive studies are necessary to determine if topical antibiotics could effectively resolve rashes,” Kahlenberg noted.
“Nonetheless, this represents an encouraging initial step towards identifying additional treatments that could enhance inflammation management beyond conventional immunosuppressants and biologic therapies.”
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