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I read with interest the article by Schattner and Liang¹ regarding the cardiovascular burden of lupus. Cardiovascular diseases secondary to accelerated atherosclerosis are now accepted as an important cause of mortality and morbidity in patients with systemic lupus erythematosus (SLE). Lowering cholesterol levels with statin therapy is one of the main targets to reduce the morbidity and mortality of SLE.² However, these lipid-lowering agents may have unexpected immunologic effects.

An increasing number of statin-induced lupuslike syndrome cases have been recently reported.^3-5 Most cases were caused by second-generation statins such as simvastatin or atorvastatin. One case was associated with autoimmune hepatitis.⁶ Statins have also been implicated in drug-induced dermatomyositis and other types of autoimmune skin diseases such as lichen planus pemphigoides.^7-8 In all cases of statin-induced lupus, skin eruption was similar to subacute lupus erythematosus with positive antinuclear antibodies. Unlike usual drug reactions, the skin eruption was observed only many months . . . [Full Text of this Article]

Bernard Noël, MD
Lausanne, Switzerland

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RELATED ARTICLE

The Cardiovascular Burden of Lupus: A Complex Challenge
Ami Schattner and Matthew H. Liang
Arch Intern Med. 2003;163(13):1507-1510.
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