Lupus Erythematosos

In this variety the lesion commences as a reddish macule, barely elevated above the level of the surrounding skin. As it slowly but gradually increases in size, the elevation slightly increases, and small, closely adherent scales form upon the surface. The extension is peripheral, and after many months, or perhaps years, may attain the size of a coin. When it has reached a diameter of, say, one-half to three-quarters of an inch, the central and older portions begin to lose their infiltrated character, sink to the level of and even beneath the level of the skin, at the same time losing their color. This continues until we find a white depressed scar, surrounded by a still infiltrated raised reddened ring. During the progress of the lesion as described other similar ones may have appeared on neighbouring or on distant parts; but, as a rule, their number is limited. When two patches have appeared in close proximity, they may join by mutual peripheral extension. In this way the greater portion of one side, or even both sides, of the face may become involved by the disease. Such extensive invasion, however, is the result of years, as cases are met with in which the lesions have been gradually extending in this manner for twenty years or more, the older portions of the lesion undergoing the retrogressive changes we have noticed.


The favourite seat of all varieties of lupus is the face, although other parts may be attacked as well, and even to the exclusion of the face.

Epithelioma may develop upon the site of a long-existing erythematous lupus, or in the neighborhood of lupous lesions.