Last reviewed: 16 Sep 2021
Last updated: 17 Dec 2019

Summary

Definition

History and exam

Key diagnostic factors

  • disc-shaped erythematous maculopapular scaly lesions
  • age 20 to 40 years
  • history of ultraviolet light exposure
  • smoking history

Other diagnostic factors

  • absence of pruritus and/or pain
  • telangiectasia, hyperpigmentation and/or hypopigmentation
  • permanent scarring alopecia
  • systemic features (arthritis, pleuritis, pericarditis, seizures, psychosis)

Risk factors

  • age 20 to 40 years
  • ultraviolet light exposure
  • smoking
  • female sex
  • non-specific skin injury

Diagnostic investigations

1st investigations to order

  • antinuclear antibodies, double-stranded (ds) DNA
  • FBC
  • ESR
  • urea and electrolytes
  • urinalysis

Treatment algorithm

Contributors

Authors

Meng May Chee, MBChB, MRCP

Consultant Rheumatologist

Wishaw General Hospital

Wishaw

UK

Disclosures

MMC declares that she has no competing interests.

Rajan Madhok, MD, FRCP(Glasg)

Consultant Physician and Rheumatologist

Department of Rheumatology

Glasgow Royal Infirmary

Glasgow

UK

Disclosures

RM has declared a stock holding in GSK.

Peer reviewers

Jeffrey P. Callen, MD

Professor of Medicine (Dermatology)

University of Louisville

Louisville

KY

Disclosures

JPC declares that he has no competing interests.

Mark Goodfield, MD

Consultant Dermatologist

Department of Dermatology

Leeds General Infirmary

Leeds

UK

Disclosures

MG declares that he has no competing interests.

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