BACKGROUND: Discoid lupus erythematosus (DLE) is a chronic inflammatory disorder 
mediated by Th1 cells. Apremilast is a novel oral PDE4 enzyme inhibitor capable 
of blocking leukocyte production of IL-12, IL-23, TNF-a, INF- with subsequent 
suppression of Th1 and Th17-mediated immune responses, and proven clinical 
efficacy for psoriasis as well as rheumatoid and psoriatic arthritis.
OBSERVATIONS: Cutaneous Lupus Erythematosus Disease Area and Severity Index 
(CLASI) showed a significant (P<0.05) decrease after 85 days of treatment with 
apremilast 20 mg twice daily in 8 patients with active discoid lupus. The 
adverse events related to the drug were mild and transient.
CONCLUSIONS: This is the first open label study to use apremilast as a treatment 
modality for discoid lupus. Our observations indicate that apremilast may 
constitute a safe and effective therapeutic option for DLE.