DISCOID LUPUS ERYTHEMATOSES

Diagnosis: DISCOID LUPUS ERYTHEMATOSES

Case submitted by Dr.Azeem Alam Khan to the dermRounds community.

Clinical Presentation

Clinical photograph(s) submitted for peer review and discussion.

Clinical History

Submitted by Dr.Azeem Alam Khan. Originally posted June 10, 2009.

Treatment

See case discussion.

Differential Diagnosis

• Subacute cutaneous lupus erythematosus • Psoriasis • Lichen planus • Tinea faciei • Granuloma annulare • Sarcoidosis • Morphea • Actinic keratosis

Key Learnings

• Most common form of chronic cutaneous lupus — only ~5-10% progress to SLE • Classic triad: erythema, scale with follicular plugging, and atrophic scarring • Carpet tack sign: adherent scale with follicular plugging seen on underside of removed scale • Scarring alopecia is a significant complication — early treatment prevents permanent hair loss • DIF (lupus band test): granular deposits of IgG, IgM, IgA, and C3 at DEJ in lesional skin • Dyspigmentation (central hypopigmentation with peripheral hyperpigmentation) especially prominent in darker skin • More common in African Americans and women

Tags: discoid, lupus, erythematoses, dr.azeem alam khan