Table 1.

Level and subtype-specific distribution of evidence for cutaneous lupus erythematosus treatments. Evidence level: +/− = weak or controversial support; + = support limited to case reports or similar; ++ = support limited to non-randomized studies or similar; +++ = support limited to randomized trials or similar. Evidence distribution: check mark = corresponding literature explicitly demonstrates favorable response to the treatment in this subtype; question mark = corresponding literature only provides weak or controversial support for treatment in this subtype; x mark = corresponding literature explicitly demonstrates little or no response to the treatment in this subtype; blank = majority of literature does not explicitly address effects of the treatment in this subtype.

Treatment	Evidence Level	Evidence Distribution
		ACLE	SCLE	DLE	LEP	LET	Bullous LE
Topicals
Topical corticosteroids	+++	✓	✓	✓	✓	✓
Calcineurin inhibitors	+++	✓	✓	✓	✓	✓
Vitamin D derivatives	+	✓	✓	✓	✓	✓
Antimalarials
Hydroxychloroquine	+++	✓	✓	✓	✓	✓
Chloroquine	+++	✓	✓	✓	✓	✓
Quinacrine	++	✓	✓	✓	✓	✓
Retinoids
Acitretin	+++	✓	✓	✓
Isotretinoin	++	✓	✓	✓
Alitretinoin	+	✓	✓	✓
Immunosuppressives
Methotrexate	++	✓	✓	✓	✓
Mycophenolate mofetil	++	✓	✓	✓	✓	✓
Azathioprine*	+/−	?	?	?	?	?
Immunomodulators
Dapsone	++	✓	✓	✓	✓	✓	✓
Thalidomide	++	✓	✓	✓	✓	?
Lenalidomide	++	✓	✓	✓
Biologics
Rituximab	++	✓	✗	✗	✗		✓
Belimumab	+		✓
Ustekinumab	+			✓	✓
Tocilizumab	+					✓
Laser Therapy
Pulsed dye laser	++	✓	✓	✓	✓	✓

^*Though evidence supporting its use in CLE is weak, azathioprine may be used in pregnancy if no alternatives are available.

ACLE = acute cutaneous lupus erythematosus; SCLE = subacute cutaneous lupus erythematosus; DLE = discoid lupus erythematosus; LEP = lupus erythematosus panniculitis; LET = lupus erythematosus tumidus