Lupus Erythematosus Panniculitis in Pregnancy and Antimalarials.

Sir,

This is in reference to your case report “Lupus erythematosus panniculitis in pregnancy” published in the Indian Journal of Dermatology 2015;60:637.[1] I wholeheartedly appreciate the efforts of the authors in diagnosing and treating this case and also sharing their valuable experience. However, there are a few points in the manuscript that concern me and should have been taken care of. First and the foremost, the authors have mentioned that the patient was treated with corticosteroids as antimalarials are contraindicated in pregnancy. This statement, however, is not appropriate as antimalarials can be safely administered during pregnancy. Lupus erythematosus patients, who become pregnant, should continue hydroxychloroquine as there is an increased risk of flares on its discontinuation.[23] It does not appear to cause toxicity to the fetus and is also compatible with breastfeeding.[34] Therefore, pregnancy should not have not been the point for starting corticosteroids and avoiding antimalarials. This statement, thus, is misleading for the readers.

Secondly, when a diagnosis of lupus erythematosus panniculitis was made, I suggest that the patient should have been screened for antiphospholipid antibody syndrome too as this may result in foetal complications including foetal loss.[4]

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