Discoid lupus erythematosus

Last reviewed: 27 Oct 2022
Last updated: 02 Nov 2022

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
More key diagnostic factors

Other diagnostic factors

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

Risk factors

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

Diagnostic investigations

1st investigations to order

  • antinuclear antibodies, double-stranded (ds) DNA
  • FBC
  • ESR
  • urea and electrolytes
  • urinalysis
More 1st investigations to order

Investigations to consider

  • skin biopsy
More investigations to consider

Treatment algorithm

ONGOING

non-severe localised/limited disease

severe or refractory localised/limited disease; disseminated disease

Contributors

Authors

Meng May Chee, MBChB, MRCP

Consultant Rheumatologist

Wishaw General Hospital

Wishaw

UK

Disclosures

MMC declares that she has no competing interests.

Girish Gupta, MBChB, FRCP

Consultant Dermatologist

Lauriston Building

NHS Lothian

Edinburgh

UK

Disclosures

GG is an advisory board member of Almirall and Viatris. GG has also been reimbursed for consultancy work by Galderma and AbbVie.

Acknowledgements

Dr Meng May Chee and Dr Girish Gupta would like to gratefully acknowledge Dr Rajan Madhok, the previous contributor to this topic.

Disclosures

RM declared holding shares in GSK to the value of less than £12,000.

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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