Diagnosis: Discoid Lupus Erythematosus
Erythema, hyperpigmentation, hypopigmentation, scarring and scaling affecting sun-exposed areas. Case submitted by Dr. Azeem Alam Khan to dermRounds.
Erythema, hyperpigmentation, hypopigmentation, scarring and scaling can be seen together. Most commonly affects the upper body, especially in sun-exposed areas. Can lead to hair loss such as in the scalp.
Case submitted by dermatologist Dr. Azeem Alam Khan to dermRounds Dermatology Network. Originally published on archive.dermrounds.com.
Can be triggered by exposure to sunlight. Smoking can exacerbate this condition. Treatment includes strict sun protection, and may include topical treatments such as corticosteroids, and systemic immunosuppressants and immunomodulators.
• Subacute cutaneous lupus erythematosus • Psoriasis • Lichen planus • Tinea faciei • Granuloma annulare • Sarcoidosis • Morphea • Actinic keratosis
• 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: lupus, autoimmune, sun-exposed, scarring alopecia, DLE