There have been no studies to date that have explicitly explored which medicines may and cannot be used safely to treat acne vulgaris in lupus erythematosus patients (LE). Certain acne medicines, such as photosensitivity and hypercoagulability, may worsen LE symptomology in these individuals, necessitating a highly personalised therapeutic approach. In this systematic review, we look at the safety results of widely given oral acne medicines, particularly in the setting of LE. A PubMed/MEDLINE literature search yielded 146 papers, 13 of which matched the requirements. Researchers assigned a degree of evidence to each research and sought evidence-based recommendations for each medication class; each suggestion was then awarded a grade. There was very few high-quality research on this subject. Although we based our recommendations on available research, the grade was occasionally negative due to the low quality of the evidence supporting the advice. However, in the context of LE, our suggestion against the use of combination oral contraceptive tablets and in favour of spironolactone for acne therapy obtained a good rating (grade A).

While no definitive recommendations for the treatment of acne in LE can be made based on the current quality and quantity of studies available, the purpose of this article is to provide a comprehensive overview and analysis of oral acne medication safety in patients with LE, while emphasising the critical need for higher quality studies and distinct acne treatment guidelines for this vulnerable patient population.