Discoid lupus erythematosus: A case report with review of the literature

Abstract

Discoid lupus erythematosus (DLE) is the most common form of chronic cutaneous lupus erythematosus. Classic DLE lesions begin as red-purple macules, papules or small plaques and rapidly develop a hyperkeratotic surface. Most patients with untreated classic DLE lesions suffer indolent progression to large areas of cutaneous dystrophy and scarring alopecia that can be psychosocially devastating. A 68-year-old male patient presented with non-healing ulcers of the mouth since 6 months and skin lesions since 2 months. Examination revealed erythematous, disc-like, scaly plaques over the face, nose and scalp, showing signs of healing accompanied by scarring and hypopigmentation. Histopathologic examination verified a diagnosis of DLE. Topical steroids and antifungals were applied to the lesions twice daily for 2 weeks. After 2 weeks of application, all lesions regressed significantly. Follow-up is important and necessary every 6 months because DLE is considered as a pre-cancerous condition and for the early detection of systemic lupus erythematosus and to minimize scarring. The recent advances in the diagnostic criteria and treatment have also been highlighted.