American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the typical treatment for systemic lupus erythematosus (SLE) with skin involvement?

1. Corticosteroids

2. Hydroxychloroquine

3. Mycophenolate mofetil

4. Azathioprine

The correct answer is: Hydroxychloroquine

Hydroxychloroquine is often considered the typical treatment for systemic lupus erythematosus (SLE) that includes skin involvement due to its effectiveness in managing both systemic and dermatological symptoms associated with the disease. This medication improves skin manifestations such as rashes and lesions while also providing anti-inflammatory effects, which helps in controlling disease activity. Hydroxychloroquine is favored because it has a favorable side effect profile compared to more potent immunosuppressive agents. It not only addresses the skin involvement but also reduces the risk of flares in systemic SLE. In many cases, it can be used as a long-term therapy to maintain remission, prevent new skin lesions, and minimize the need for systemic corticosteroids, which are associated with various side effects when used long-term. While corticosteroids, mycophenolate mofetil, and azathioprine are also used in the management of SLE, they are typically reserved for more severe manifestations of the disease or when hydroxychloroquine alone is insufficient. Corticosteroids can address inflammation rapidly, but they carry a risk of significant side effects. Mycophenolate mofetil and azathioprine are stronger immunosuppressive agents, primarily utilized in cases with major