Number 4

Abstract

This patient has had edematous, red, symmetrical areas of the cheeks and chin for several weeks. She feels tired and feverish and has vague aches and pains. Pyrexia, plus a positive L.E. test, elevated sedimentation rate, albuminuria, and white blood cell count of 4,100, confirm the presence of acute, life-threatening, systemic lupus erythematosus. Slowly spreading lesions have been present for several years. There is scaling, redness, telangectasia, and atrophic scarring. With a magnifying glass, dilated follicles containing a horny plug are seen. The patient feels well. After finding that the blood count, urinalysis, serum proteins, L.E. test preparation, and serologic test for syphilis were normal, and having confirmatory histopathologic findings, a diagnosis of discoid lupus erythematosus was made. These pink papules, becoming confluent, caused only mild itching. A few scattered early vesicles could be seen with a magnifier. The process appeared in the spring of the year and the mother