
Systemic lupus erythematosus (SLE), commonly known as lupus, is a complex autoimmune disease that presents a variety of symptoms and poses significant challenges in treatment.
One common form of lupus is cutaneous lupus erythematosus, which manifests as rashes on the face, scalp, and other parts of the body, leading to hair loss and skin scarring. These rashes are caused by inflammation resulting from the immune system attacking the body.
Traditional treatments for cutaneous lupus erythematosus involve immunosuppressants and biologic drugs to reduce inflammation. However, many patients with lupus already take multiple medications and are seeking alternative treatments.
A research team led by Dr. J. Michelle Kahlenberg, a professor of internal medicine at the University of Michigan Health, has been exploring one such alternative: a topical treatment called mupirocin. This study builds on Dr. Kahlenberg’s previous discovery that cutaneous lupus rashes are often colonized by a common skin bacteria, Staphylococcus aureus (staph), which contributes to inflammation.
Mupirocin is known to kill staph bacteria. In the study, patients with SLE who were experiencing cutaneous lupus flares were randomly selected to treat their skin lesions with either mupirocin or an inactive control, petrolatum jelly. Samples from the nose and affected skin were analyzed before and after treatment to measure staph levels and microbial community profiles.
Results showed that mupirocin treatment significantly decreased staph levels in the affected skin, which corresponded with a reduction in inflammatory signals, including interferon-driven gene expression. Dr. Kahlenberg noted that mupirocin also lowered skin monocyte levels, which are crucial in driving cutaneous lupus.
While these findings indicate that mupirocin can reduce inflammation, the study did not determine whether it can completely eliminate the rashes associated with cutaneous lupus erythematosus. Dr. Kahlenberg emphasized the need for larger studies to evaluate the effectiveness of topical antibiotics in treating these rashes.
Despite the need for further research, this study marks an exciting first step toward discovering additional treatments that can reduce inflammation beyond the conventional use of immunosuppressants and biologic drugs.