This section is from the book "Materia Medica And Therapeutics Inorganic Substances", by Charles D. F. Phillips. Also available from Amazon: Materia medica and therapeutics.
In erythematous lupus, and in early stages of the tubercular and markedly strumous forms, strong iodine paint is sometimes useful; equal parts of pure iodine and iodide of potassium, in two parts glycerin, may be used about twice weekly; this excites "substitutive irritation," and exerts some absorptive power, though I have not myself seen curative results from it. The plain tincture of iodine relieves the congested livid condition of the neighboring skin if painted over it. Iodoform deserves a very careful trial (v. p. 86). VOL I. - 6
I have mentioned the external use of iodine in the treatment of this disease (v. p. 81), and there is some evidence in favor of its internal employment. Thus, Mr. Gay records cases of lupus affecting the face - in one man for seven years, in a woman for twenty years - which yet got well under 1/2-dr. doses of iodide of potassium (Medical Times, ii., 1871). There was no obtainable history or distinct evidence of syphilis, though one cannot but suspect a syphilitic taint in such cases. I have never known iodides cure ordinary lupus, nor is it a common experience. Dr. Mackey has noted two cases, in one of which the nose was affected, in the other the nose and scalp; ulceration was deep, indolent, and slowly progressive, in spite of caustic treatment; discharge was but slight, crusts formed at the edges, and the cases resembled true lupus, except that there were no tubercles, and the patients (men) were between forty and fifty years of age when the sores commenced. Both recovered quickly under the influence of iodide of potassium and mercurial lotions; but, although there was no history of syphilis, the probability remains in favor of its existence in similar cases.
In the erythematous form the glacial acid may be applied about twice weekly, with much advantage and without production of scarring.
For Frost-Bite, vinegar applied with friction is a good external application.
The same application is indicated for the indolent edges of an ulcerating lupus, though acid nitrate of mercury is perhaps better.
There are differences of opinion as to its value in lupus: Mr. Hunt, for instance, and Mr. Milton esteeming it highly, and recommending its continuous administration for months or years; but others, and, indeed, the majority of observers, recording no definite result from it. I have never been able to satisfy myself that it controlled the disease, although the local caustic effect is, as already mentioned, highly valuable.
Ichthyosis is congenital, and, though it may be relieved, is scarcely curable; the evidence as to the value of arsenic in its treatment is but slight.
For cases of ulcerative lupus in which the strumous character is most marked, caustic potash is sometimes a good agent; we do not apply it generally for lupus about the face, because of the unsightly cicatrix which is apt to follow its use; but in Vienna it is in frequent request, and is found to succeed when other remedies have failed.
The acetate of soda, though not often used, has remarkable power in lessening the granulations and crusting of strumous and lupoid ulceration: a lotion containing from 10 to 20 gr. in the ounce of water may be applied on compress, or injected into sinuses. In lupus the solid crystals may be lightly applied for a caustic effect (Anderson: Lancet, ii., 1869).