Describe the skin changes of discoid lupus erythematosus.
| | Fig. 22.3 Discoid lupus erythematosus. A, Fixed, erythematous, scaly discoid plaques of DLE with central atrophy on the upper arms. B, DLE lesion in the concha of the ear. Hypopigmented and hyperpigmented areas, erythema, and scarring are present. (Panel A courtesy of the John L. Aeling, M. D. Collection.) | DLE is a chronic inflammatory disease consisting of fixed, indurated, erythematous papules and plaques that are often distributed on the head and neck, although any cutaneous region can be affected (Fig. 22-3A). Without intervention, DLE lesions may last for many years and are associated with extensive scarring, a feature that helps distinguish DLE from SCLE. When DLE occurs on the scalp, permanent scarring alopecia may result. Pigmentary changes, both hyperpigmentation and hypopigmentation, are also frequently associated with lesions of DLE. Epidermal changes, including scale, keratotic plugging of the hair follicles, and sometimes crusting, are also generally present. The external ears are often involved in DLE (Fig. 22-3B); thus, this area should be carefully examined in patients with suspected DLE. |
