What is the most pertinent follow-up for a woman with discoid lupus who did not respond to her current treatment?

In the context of a woman with discoid lupus who has not responded to her current treatment, considering higher immunosuppressive therapy is a highly pertinent follow-up. Discoid lupus erythematosus (DLE) primarily affects the skin, presenting as disc-like lesions, and while corticosteroids are often used as a first-line treatment, their effectiveness can vary significantly among individuals. If a patient does not achieve adequate control of her symptoms, it indicates that the current treatment plan may not be sufficient.

Increasing the dosage of corticosteroids might provide some additional anti-inflammatory effects, but it does not address the underlying issue if the patient is already steroid-dependent or if the current regimen is inadequate. Similarly, while referral for dermatological intervention can be useful for specialized treatment options like topical therapies or photoprotection, it may not suffice in cases where deeper immunosuppression is warranted.

Starting physical therapy, on the other hand, is generally not indicated for discoid lupus as it does not directly relate to the treatment of skin lesions or systemic involvement that may be present in lupus. Therefore, considering higher immunosuppressive therapy is appropriate, as this approach targets the autoimmune process more aggressively, which may provide better control of the disease and improve the patient's overall