Unilateral discoid lupus erythematosus over the face: An unusual presentation

Discoid lupus erythematosus is the most common forms of chronic cutaneous lupus erythematosus. It is characterized by clinical manifestations of erythematous macules, papules, or plaques with a coin-like shape and the face is the most common predilection site. Clinical features often resemble granuloma faciale. This case report aimed to distinguish discoid lesions on the face based on the histopathological examination. A 71-year-old male with a few reddish lumps appeared on his face since three months ago. Physical examination showed multiple discrete erythematous plaques with overlying squamous. Hematoxylin and eosin staining on the epidermis demonstrated basket weave type orthokeratosis, basal vacuolar cell degeneration, epidermal atrophy with flat rete ridges, and follicular plugging while in the dermis obtained inflammatory cell infiltrates, especially in periadnexal areas. Histopathological features of DLE are hyperkeratosis, pilosebasea gland atrophy, follicular plugging, basal membrane thickening, and cellular infiltrate in periadnexa or perivascular areas more visible than in other types of CLE. In DLE, no subepidermal gren zone and eosinophil infiltrate were found, like histological features of granuloma faciale. Histopathological examination can be used to establish a diagnosis for discoid lesions on the face, although serology examination remains as the gold standart. Keywords: Discoid lupus erythematosus; Granuloma faciale; Histopathology

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Erysipelas complicating chronic discoid lupus erythematosus of the face-a case report and review of erysipelas

Clinical and Experimental Dermatology ◽

10.1111/j.1365-2230.1989.tb00891.x ◽

1989 ◽

Vol 14 (1) ◽

pp. 75-78 ◽

Cited By ~ 8

Author(s):

M. KEEFE ◽

R.A. WAKEEL ◽

R.E.I. KERR

Keyword(s):

Case Report ◽

Lupus Erythematosus ◽

Discoid Lupus Erythematosus ◽

The Face

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Cutaneous squamous cell carcinoma causing a rhinophymatous mass in a patient with clinically occult hypertrophic lupus erythematosus

Lupus ◽

10.1177/0961203320912838 ◽

2020 ◽

Vol 29 (6) ◽

pp. 644-648 ◽

Cited By ~ 1

Author(s):

Leah Cohen ◽

Vidhi Shah ◽

Pei-Ling Chen ◽

Jane Messina ◽

Lucia Seminario-Vidal

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Lupus Erythematosus ◽

Final Diagnosis ◽

Cutaneous Squamous Cell Carcinoma ◽

Upper Extremities ◽

Discoid Lupus Erythematosus ◽

The Face ◽

Work Up

Hypertrophic lupus erythematosus is a variant of discoid lupus erythematosus, which manifests as verrucous plaques and/or keratoacanthoma-like nodules on the face and arms. Diagnosis and treatment of hypertrophic lupus erythematosus can be challenging as it can resemble cutaneous squamous cell carcinoma clinically and histopathologically. Furthermore, cutaneous squamous cell carcinoma is a known complication of discoid lupus erythematosus. We present a diagnostically challenging case of a patient with a rapidly enlarging rhinophymatous mass and multiple keratoacanthoma-like lesions of the bilateral upper extremities whose work-up was initially equivocal. CD123 staining helped to elucidate a final diagnosis of cutaneous squamous cell carcinoma arising in a background of occult hypertrophic lupus erythematosus.

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Squamous Cell Cancer Arising in an African American Male Cheek from Discoid Lupus: A Rare Case and Review of the Literature

Case Reports in Surgery ◽

10.1155/2016/9170424 ◽

2016 ◽

Vol 2016 ◽

pp. 1-3

Author(s):

Emanuel A. Shapera ◽

Paul D. Kim

Keyword(s):

African American ◽

Squamous Cell ◽

Lupus Erythematosus ◽

Rare Case ◽

African American Male ◽

Cell Cancer ◽

Neck Surgery ◽

Discoid Lupus Erythematosus ◽

Dermatology Clinic ◽

The Face

A 50-year-old African American male with Discoid Lupus Erythematosus (DLE) presented to the dermatology clinic for a rapidly enlarging left cheek mass. The mass failed to resolve with conservative measures. A biopsy revealed poorly differentiated Squamous Cell Carcinoma (SCC). He was referred to Head and Neck Surgery and successfully underwent a resection with free flap reconstruction. Postoperatively he did well. Squamous cell skin carcinomas arising from lesions of Discoid Lupus are rare and aggressive tumors with greater likelihood of metastases. Cases have been reported among patients with different clinical characteristics; we present a rare case arising in an African American male on the face and involving the ear.

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Tinea incognito: Clinical perspectives of a new imitator

Dermatology Reports ◽

10.4081/dr.2020.8323 ◽

2020 ◽

Vol 12 (1) ◽

Author(s):

Samer Dhaher

Keyword(s):

Lupus Erythematosus ◽

Skin Diseases ◽

Clinical Manifestations ◽

Skin Lesions ◽

Systemic Steroid ◽

Discoid Lupus Erythematosus ◽

Wide Range ◽

The Face ◽

Tinea Incognito ◽

A Prospective Study

Tinea incognito is a variant of dermatophyte infection of the skin modified by an erroneously applied topical or systemic steroid. Aim of the study: to describe the various clinic-epidemiological aspects of tinea incognito found among our patients. A prospective study was carried out in the Department of Dermatology, Basra Teaching Hospital, Basra, Iraq. The clinical diagnosis was confirmed by mycological tests. Clinical data were described in more detail and the lesions were classified according to the site, shape, and extent. Ninety cases of tinea incognito were seen, median age was 34years. The initial inaccurate diagnoses were eczema in 60 patients (67%), intertrigo in 16 (18 %) and psoriasis in 14 (15%) patients. The type of topical drugs applied was topical corticosteroid (potent and fluorinated) in most cases (54.4%), fixed drug combination creams in 36.6% and a topical calcineurin inhibitor in 5.5%. Commonly presented as acute eczema-like, on hands and trunk, discoid lupus erythematosus-like lesions on the face and psoriasiform lesions on the scalp. Due to the wide range of clinical manifestations, tinea incognito imitates many skin diseases and should, therefore, be considered in any chronic, erythematous, scaly skin lesions not responding to topical treatment.

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Efficacy and Safety of Pimecrolimus Cream (1%) in the Treatment of Discoid Lupus Erythematosus

Medicine Today ◽

10.3329/medtoday.v30i2.37809 ◽

2018 ◽

Vol 30 (2) ◽

pp. 53-56

Author(s):

Md Anwar Husain ◽

Md Rezaur Rahim ◽

Mohd Nurul Alam ◽

Md Rafiqul Haque ◽

Md Rashidul Hasan ◽

...

Keyword(s):

Lupus Erythematosus ◽

Response To Treatment ◽

Discoid Lupus Erythematosus ◽

Double Blind Study ◽

Similar Response ◽

Efficacy And Safety ◽

Double Blind ◽

Medical College ◽

The Face ◽

Severe Type

Discoid lupus erythematosus (DLE) is commonly treated with topical agents, the most important of which are glucocorticosteroids. However, prolonged use of these agents, especially on sensitive areas such as the face, may result in side-effects (e.g. atrophy and telangiectases) by altering collagen synthesis. This was a randomized doubleblind pilot study, performed in Department of Dermatology & VD, Ibn-Sina Sina Medical College, Dhaka. Seventy four patients aged 20-53 years with moderate to severe DLE of the face were randomized 8 weeks of treatment and 8 weeks of follow-up after treatment. In this double-blind study, one group applied pimecrolimus 1% cream twice daily to facial lesions. Efficacy end-points included a combined score based on evaluation of erythema, infiltration and presence of scale. This study was conducted to evaluate the efficacy and safety of topical pimecrolimus 1% cream in discoid lupus erythematosus. It was observed that before treatment, erythema was severe in 43.2% cases, moderate in 51.4% cases and mild type erythema was present in 5.4% cases. The post-treatment revealed, 29.7% severe type erythema, none evidenced moderate type erythema, only 43.2% had mild type and 27% cases no erythema at all. Before treatment, infiltration was severe in 27% cases, moderate in 54.1% cases and only 18.9% had mild type infiltration. But after treatment, 10.8% had severe type infiltration, 18.9% had moderate, 51.4% had mild and 18.9% had no infiltration at all. Similar response to treatment was noticed with squamation which exhibited a drop from 37.8% to 18.9% in severe cases and from 62.2% to 10.8% in moderate cases. There was a 45.9% mild case and 24.3% had no squamous. It was interpreted that score of patients of DLE, before treatment was 6.78±1.36 and after treatment was 3.97±1.21. Improvement was shown in 70.3 cases and 29.73 cases shown no improvement at all. This study suggest that pimecrolimus cream for discoid lupus erythematosus seems to be a safe and clinically effective option. However, this was an open and uncontrolled study, and double-blind, placebo-controlled studies are needed.Medicine Today 2018 Vol.30(2): 53-56

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Linear discoid lupus erythematosus mimicking en coup de sabre morphea: A case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x19882843 ◽

2019 ◽

Vol 7 ◽

pp. 2050313X1988284 ◽

Cited By ~ 1

Author(s):

Mahdi Hassan ◽

Kevin A Watters ◽

Elena Netchiporouk

Keyword(s):

Lupus Erythematosus ◽

Calcineurin Inhibitors ◽

Skin Lesions ◽

Discoid Lupus Erythematosus ◽

Topical Steroids ◽

First Case ◽

Full Physical Examination ◽

Linear Configuration ◽

The Face

Discoid or chronic lupus erythematosus is an autoimmune disease that produces skin lesions on the face and scalp. Rarely do lesions present with linear configuration, but when they do, the lesions often follow the lines of embryologic migration. A 24-year-old man presented with a slowly progressing asymptomatic violaceous linear patch running from the root of his frontal scalp to the nasal tip. A Doppler ultrasound and skin biopsy were performed and the histological findings demonstrated characteristic findings of discoid lupus erythematosus. A full physical examination, review of systems and laboratory investigations showed no indication of systemic lupus. High potency topical steroids and calcineurin inhibitors were prescribed along with photoprotection. At 4-month follow-up, all his lesions had mostly cleared. We report here the first case, to our knowledge, of discoid lupus erythematosus with en coup de saber presentation mimicking morphea.

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Annular Atrophic Plaques of the Face. An Entity or an Annular Atrophic Discoid Lupus erythematosus?

Dermatology ◽

10.1159/000251545 ◽

1974 ◽

Vol 149 (6) ◽

pp. 379-384 ◽

Cited By ~ 7

Author(s):

S. Jablonska ◽

T. Chorzelski ◽

W. Mazurkiewicz

Keyword(s):

Lupus Erythematosus ◽

Discoid Lupus Erythematosus ◽

The Face

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