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Lupus erythematosus, discoid I
OVERVIEW: Discoid lupus erythematosus (DLE) is the most common form of chronic cutaneous lupus. It is a chronic skin disease characterized by sharply marginated dull, red macules with adherent scales extending into areas of atrophy, telangiectasias, or follicular plugging
• Localized DLE - more common form with lesions occurring on the face especially the malar areas, bridge of nose, lower lip, lower eyelids and ears
• Widespread DLE - lesions seen on upper extremities and thorax
System(s) affected: Skin/Exocrine
Genetics: N/A
Incidence/Prevalence in USA:
• 3/100,000 Caucasian females; 8/100,000 black females
• 100/100,000
Predominant age: 25 to 45
Predominant sex:
• Localized DLE - Female > Male (3:1)
• Widespread DLE - Female > Male (9:1)
SIGNS AND SYMPTOMS: • Red plaque-like lesions on face, thorax, or extensor aspect of upper extremities; rare below waist
• Older lesions atrophy and appear as smooth white or hyperpigmented scars with telangiectasias
• Scarring alopecia with scalp lesions
• Carpet tack appearance of skin when scale removed
• Lesions occasionally slightly pruritic or stinging
• Oral ulceration in 15 percent of patients
• Photosensitivity
• Koebner response (precipitation by cutaneous trauma)
CAUSES: Unknown
RISK FACTORS: Systemic lupus erythematosus (SLE)
DIAGNOSIS DIFFERENTIAL DIAGNOSIS: • Actinic keratoses
• Polymorphous light eruption
• Drug eruptions
• Sarcoid
• Cutaneous leishmaniasis
• Lupus vulgaris
• Seborrheic dermatitis
• Lichen planus
• Plaque psoriasis
• Rosacea
• Pemphigus erythematosus
• Tinea faciei
• Jessner-Kanof disease
• Granuloma faciale
LABORATORY: • Localized DLE: positive ANA in low titer (30%)
• Widespread DLE, may occasionally find, increased sedimentation rate, positive ANA (30-40%), positive dsDNA (< 5%), leukopenia, hematuria and albuminuria if concomitant SLE
Drugs that may alter lab results: N/A
Disorders that may alter lab results: Concomitant SLE
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