Discoid lupus erythematosus

Last reviewed: 10 Jul 2022
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
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

all patients

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.

  • Discoid lupus erythematosus images
  • Differentials

    • Systemic lupus erythematosus (SLE)
    • Subacute cutaneous lupus erythematosus (SCLE)
    • Psoriasis
    More Differentials
  • Guidelines

    • S2k guideline for treatment of cutaneous lupus erythematosus - guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV)
    More Guidelines
  • Patient leaflets

    Psoriasis

    More Patient leaflets
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