Discoid Lupus Erythematosus

Key Points
Most common form of Cutaneous Lupus Erythematosus (LE), typically affects the nose, ears, and/or cheeks
Autoimmune disorder in which the nuclei of skin cells are attacked
Consists of scaly patches of skin which are red in color and result in changes of surrounding Pigmentation and scarring of the affected area

Discoid Lupus Erythematosus is the most common form of Cutaneous Lupus Erythematosus (LE), and typically affects the nose, ears, and/or cheeks, though it may appear in other areas such as upper torso, neck, and hands. The condition consists of scaly patches of skin which are red in color and result in dyspigmentation and scarring of the affected area. The condition may involve hair follicles, resulting in permanent alopecia in some cases, and may also affect the lips and mouth interior, resulting in scaling and ulceration. In cases involving the mouth, lesions may be vulnerable to developing Squamous Cell Carcinoma.

Discoid Lupus Erythematosus is an autoimmune disorder in which the nuclei of skin cells in the affected area are attacked by the immune system. This response is very often triggered by exposure to sunlight, and the condition's effects are more severe in those who smoke. The condition most commonly appears in adult women, but may also develop in males, children, and older persons.

Differential Diagnosis (Other conditions with similar appearance)

Actinic Keratosis
Psoriasis
Dermatomyositis
Rosacea
Granuloma annulare
Sarcoidosis
Granuloma faciale
Squamous Cell Carcinoma
Keratoacanthoma
Syphilis
Lichen Planus
Warts
Subacute Cutaneous Lupus erythematosus

Diagnosis
Key Points
Diagnosis based on the characteristic appearance of the affected area in conjunction with various laboratory and blood tests
Skin biopsy may be performed to confirm diagnosis and rule out similar appearing conditions

Discoid Lupus Erythematosus is diagnosed based on the characteristic appearance of the affected area in conjunction with various laboratory and blood tests. A skin biopsy may be performed to confirm the diagnosis and to rule out similar appearing conditions.

Treatment
Goal of treatment is to relieve visible symptoms and prevention of scarring
Limiting sun exposure and ceasing smoking is recommended
Several treatments are available which may be of benefit to affected persons

The goal of treatment of Discoid Lupus Erythematosus is to relieve visible symptoms and to prevent scarring if possible. Health care professionals may recommend limiting sun exposure and ceasing smoking to prevent these stimuli from exacerbating the condition. Several treatments are available which may be of benefit to affected persons, including topical medications such as steroids, calcineurin inhibitors(such as Pimecrolimus and Tacrolimus). Other medications which may be prescribed with varying effect include corticosteroid Injections, antimalarials, Systemic steroids, and even vascular laser therapy. A wide range of medications may be used to treat severe cases, including retinoids, Methotrexate, Thalidomide, Cyclosporine, Gold, Dapsone, Cyclophosphamide, Clofazamine, IV Immunoglobulin, and Biological response modifiers.