Differentiating drug-induced lupus erythematosus from other diseases

As a reminder, rheumatologic conditions tend to declare themselves over time, as opposed to immediately displaying all the classic clinical manifestations of the disease.

There is an inherited difficulty in distinguishing true drug-induced autoimmunity from an exacerbation of pre-existing autoimmunity or unmasking of a second autoimmune disease. It will become even more important to recognize medication-induced lupus syndromes given the expanding list of medications associated with DIL.

Here are possible differentials to DIL:

• Idiopathic systemic lupus erythematosus
• Systemic sclerosis (scleroderma)
• Rheumatoid arthritis
• Connective tissue diseases
• Granulomatosis with polyangiitis
• Fibromyalgia
• Lichen planus
• Chronic radiation dermatitis
• Rosacea
• Psoriasis
• Dermatomyositis
• Granuloma annulare
• Actinic keratosis

https://www.visualdx.com/visualdx/diagnosis/drug-induced+lupus+erythematosus?diagnosisId=51883&moduleId=101 https://www.thepermanentejournal.org/issues/43-the-permanente-journal/original-research-and-contributions/7458-drug-induced-lupus,-a-one-time-hit-or-a-harbinger-of-future-autoimmunity-a-case-report.html

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