Home   Chapter Home   Jobs   Conferences   Fellowships   Books

Advertisement

Skin-nontumor / Clinical Dermatology

Other dermatoses

Lupus erythematosus - Chronic discoid lupus

Reviewer: Mowafak Hamodat, MB.CH.B, MSc., FRCPC, Eastern Health, St. Johns, Canada (see Reviewers page)
Revised: 1 August 2011, last major update August 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

Definition
=========================================================================

● Distinct entity from systemic lupus erythematosus (SLE), despite similar names
● No systemic manifestations, although 1/3 with SLE have discoid type lesions
● Common, usually women; may be exacerbated by sunlight
● Lupus profundus: preferential lymphocytic infiltration of subcutaneous fat

Clinical description
=========================================================================

● Localized or generalized pattern
● Only 1% with localized variant develop systemic disease versus 5% with generalized variant
● May become worse during spring/summer
● Sharply circumscribed erythematous, atrophic or hyperkeratotic, shiny and scaling plaques on face, neck, scalp, arms or trunk
● Plaques may have follicular keratotic plugs

Micro description
=========================================================================

● Follicular hyperkeratosis, epidermal atrophy and acanthosis with degeneration of basal layer, periadnexal lymphocytic infiltrate
● May have flask-shaped plugs of stratum corneum filling follicular orifices
● Older lesions have thick and irregular basement membranes
● Usually reticular dermal mucin
● Rare plasma cells

Positive stains
=========================================================================

● Lupus band test - IgG, IgM, C5b-C9 (by direct immunofluorescence) in clinically involved skin as irregular band at dermoepidermal junction
● IgG and IgM in 50% in normal skin
● Also positive for mucin stains (Alcian blue, colloidal iron)

Differential diagnosis
=========================================================================

● Verrucous and hyperkeratotic chronic discoid lupus lesions on upper extremities resemble hypertrophic lichen planus or keratoacanthoma
● Also polymorphous light eruption, chronic dermatitis, Jessner’s lymphocytic infiltrate of skin

End of Skin-nontumor / Clinical Dermatology > Other dermatoses > Lupus erythematosus - Chronic discoid lupus

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).