Table 2 Summary of commonly used treatment in mucocutaneous lupus lesions in juvenile systemic lupus erythematosus (JSLE) [74–81]

1. Topical

Sunscreen

2 mg/cm², SPF >30

All sun-exposure areas apply at least 30 min before sun exposure

Greasy and allergic contact dermatitis

Topical steroids

- Mild potency

1% hydrocortisone acetate

Eyelids, face and intertriginous areas

Hypopigmentation, skin atrophy, increased hair growth and telangiectasia;

- Moderate potency

0.1% triamcinolone acetonide

Scalp and body

0.1% mometasone furoate

- High potency

0.05% clobetasone propionate

Scalp, palms and soles

0.05% betamethasone dipropionate

Intralesional steroids

2.5-10 mg/mL

Discoid lesions particularly on scalp

Skin atrophy and hypopigmentation

Calcineurin inhibitors

1% pimecrolimus

Eyelids, face and intertriginous areas (steroid-sparing effects)

Burning sensation and infection

0.03%, 0.1% tacrolimus

2. Systemic

Systemic Steroids

0.5-2 mg/kg ideal body weight per day between 2–4 weeks, followed by tapering dose

Severe skin lesions or systemic disease flare up

Osteoporosis, cushing syndrome and growth retardation

Hydroxychloroquine

- Children

5 mg/kg ideal body weight per day

Combination with systemic steroids

Ocular toxicity, gastrointestinal upset, dizziness and headache

- Young adults

6-6.5 mg/kg ideal body weight per day

(steroid-sparing effects)