{ "schema_version": 1, "kind": "condition", "id": "discoid-lupus-erythematosus", "name": "Discoid lupus erythematosus", "category": "acute", "sources": "Egyptian National Drug Formulary - Antimicrobial 2023, Hydroxychloroquine monograph, PDF page index 87 (printed p78), under \"Discoid lupus erythematosus and subacute cutaneous lupus erythematosus\" (the citation previously named p88, which is the following page). · Sukumaran S, Sathe NC. Discoid Lupus Erythematosus. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID: NBK493145. · Protopic 0.1% ointment SmPC section 4.2 (eMC product 1608)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Antimicrobial 2023, Hydroxychloroquine monograph, PDF page index 87 (printed p78), under \"Discoid lupus erythematosus and subacute cutaneous lupus erythematosus\". · Egyptian National Drug Formulary (endf-respiratory-2026.txt) · Sukumaran S, Sathe NC. Discoid Lupus Erythematosus. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID: NBK493145.", "verified_date": "2026-08", "treatments": [ { "id": 597, "generic": "Hydroxychloroquine", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "200 to 400 mg by mouth daily, as a single dose or in two divided doses - but not more than 5 mg/kg/day of actual body weight, or 400 mg daily, whichever is lower. Doses are expressed as hydroxychloroquine sulfate (200 mg sulfate = 155 mg base).", "adult_duration": "Long-term therapy. The formulary states no course length for discoid lupus.", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023, Hydroxychloroquine monograph, PDF page index 87 (printed p78), under \"Discoid lupus erythematosus and subacute cutaneous lupus erythematosus\".", "rationale": "Hydroxychloroquine is formulary-indicated by name for discoid lupus erythematosus and is the standard systemic agent for chronic disease not controlled by photoprotection and topical steroids alone.", "cautions": [ "All doses are hydroxychloroquine sulfate; 200 mg sulfate = 155 mg base.", "Eye check at baseline, then annual retinal screening from 5 years of use, or sooner if major risk factors are present.", "Do not exceed 5 mg/kg/day of actual body weight or 400 mg daily, whichever is lower - retinal toxicity.", "Systemic symptoms (joint pain, renal involvement, cytopenias) suggesting progression to systemic lupus erythematosus.", "Due to the risk of retinal toxicity, most patients should not receive a daily dose above 5 mg/kg actual body weight or 400 mg, whichever is lower; baseline and periodic ophthalmologic screening is recommended for long-term use.", "Systemic symptoms - joint pain, renal involvement, or cytopenias - suggest progression to systemic lupus erythematosus and need dermatology/rheumatology referral.", "Use with caution in G6PD deficiency and in pre-existing retinopathy or maculopathy.", "Skin diagnosis should ideally be confirmed and monitored with dermatology involvement." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "The formulary gives no paediatric lupus dose - its paediatric hydroxychloroquine section covers malaria only (chemoprophylaxis 6.5 mg/kg weekly; treatment 12.9 mg/kg then 6.5 mg/kg). Paediatric discoid lupus is a specialist decision; do not carry the malaria figures across.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "FUTARHOMAL 200 MG 20 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FUTURE PHARMACEUTICAL INDUSTRIES (FPI)", "price_egp": 40.0, "pack_count": 20, "unit_price": 2.0, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "HYDROXYTOID 200 MG 20 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 40.0, "pack_count": 20, "unit_price": 2.0, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "HYDROQUINE 200 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM", "price_egp": 82.0, "pack_count": 20, "unit_price": 4.1, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PLAQUENIL 200MG 60 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 246.0, "pack_count": 60, "unit_price": 4.1, "strength_mg": 200.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "discoid-lupus-erythematosus" }, { "id": 598, "generic": "Beclometasone", "line": 1, "is_adjunct": true, "form": "topical", "strength_mg": null, "adult_dose": "Apply 0.25 mg/g cream thinly over affected area twice daily initially; extend application interval as improvement is seen", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary (endf-respiratory-2026.txt)", "rationale": "Potent topical corticosteroid formulary-indicated for discoid lupus erythematosus to suppress local cutaneous inflammation during flares.", "cautions": [ "Avoid long-term continuous use due to risk of skin atrophy.", "Use with caution on facial skin and delicate skin folds." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Cream should be applied thinly over the whole of the affected area and gently rubbed in.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "BECLOZONE 0.025% CREAM 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "discoid-lupus-erythematosus" }, { "id": 599, "generic": "Tacrolimus", "line": 1, "is_adjunct": true, "form": "topical", "strength_mg": null, "adult_dose": "0.1% ointment applied thinly twice a day until the lesion clears", "adult_duration": "Until the lesion clears", "dose_source": "Protopic 0.1% ointment SmPC section 4.2 (eMC product 1608)", "rationale": "The card's only topical is a corticosteroid, and the article warns that chronic topical steroid on the face causes atrophy; a calcineurin inhibitor does the same job on facial lesions without thinning the skin.", "cautions": [ "Sun exposure has to be minimised while using it - hat, clothing and sunscreen - and sunbeds and UV therapy avoided. This matters doubly in discoid lupus, where sunlight drives the disease.", "Do not apply it to any lesion that could be malignant or pre-malignant, and have any new change within a treated patch looked at.", "A burning or stinging feeling for the first week or two after application is the usual side effect and settles.", "Use the lowest strength, the fewest applications and the shortest course that controls the lesion; this is not a treatment to leave running indefinitely.", "Its licensed indication is atopic dermatitis, so use in discoid lupus is off-label and should be explained to the patient." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Only the 0.03% strength is used between 2 and 16 years. Not for children under 2.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "TAROLIMUS 0.1% TOPICAL OINT. 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ANDALOUS PHARMA", "price_egp": 144.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRECZIMUS 0.1% TOPICAL OINT. 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)", "price_egp": 219.0, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROTOPIC 0.1 % OINT. 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "LEO PHARMACEUTICAL PRODUCTS", "price_egp": 407.0, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRECZIMUS 0.03% TOPICAL OINT. 20 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI)", "price_egp": 114.0, "pack_count": null, "unit_price": null, "strength_mg": 20000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TAROLIMUS 0.03% TOPICAL OINT. 15 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ANDALOUS PHARMA", "price_egp": 129.0, "pack_count": null, "unit_price": null, "strength_mg": 15000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROTOPIC 0.03 % OINT. 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "LEO PHARMACEUTICAL PRODUCTS", "price_egp": 371.0, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "discoid-lupus-erythematosus" } ] }