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Drug-Induced SCLE — SCE Dermatology MCQ

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HardDrug ReactionsDrug-Induced SCLESCE Dermatology

A 44-year-old woman presents with annular erythematous plaques with a trailing collarette of scale on her trunk and proximal limbs. She recently started a new medication. Anti-Ro (SSA) antibodies are positive. Drug-induced SCLE is suspected. She takes Omeprazole, Paracetamol, Atorvastatin, and Ramipril. Which medication is most likely responsible?

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Correct answer: D — Omeprazole

Proton pump inhibitors (including Omeprazole) are well-established causes of drug-induced SCLE. Other commonly implicated drugs include Terbinafine, thiazide diuretics, calcium channel blockers, ACE inhibitors, and TNF-alpha inhibitors. While ACE inhibitors can also cause SCLE, PPIs have a stronger and more frequently reported association in the literature. Paracetamol and statins are not commonly associated. Drug-induced SCLE resolves with drug withdrawal but may take weeks to months.

Reference: BJD 2017 Drug-induced SCLE systematic review