Discoid lupus erythematosus: Description of 130 cases and review of their natural history and clinical course

Abstract

Discoid lupus erythematosus (DLE) is one of the most common forms of cutaneous lupus erythematosus (CLE). The purpose of this study was to evaluate the clinical manifestations, laboratory findings and the natural course of Thai patients with DLE, as well as the factors that may incline DLE patients to develop systemic lupus erythematosus (SLE). We retrospectively studied 130 patients with DLE between January 2002 and December 2007. Seventy-six patients (58%) presented with a localized form of classic DLE with the primarily involved location on the face (52.3%). Fifty-nine of 130 patients (45.4%) fulfilled American College of Rheumatology criteria for SLE. Twenty-seven of 59 patients (45.7%) had DLE which preceded the diagnosis of SLE. Among these patients, 50% would progress to develop SLE 2 years from the disease onset. In our study, the presence of antinuclear antibodies (ANA) had the highest statistical relevance for distinguishing between those patients with only DLE lesions and those who would transit into SLE. Seventy one patients (54.6%) had only cutaneous lesions without fulfilling the criteria of SLE even after long-term follow up. Comparing with Caucasians’ data, our study revealed a higher percentage of positive ANA, less frequency of photosensitivity but more progression to SLE even with the same risk factors. Key words: Discoid lupus erythematosus, natural history, clinical course.