Discoid Lupus Erythematosus in a 23-Year-Old African American Woman

Note that some lesions occur within the outer ear, quite typical for the diagnosis of discoid lupus.

A 23-year-old African American woman was concerned about the appearance of discolored, tender spots on the face. She worked indoors, but played tennis outdoors several times weekly.

Key point: The lesions consist of variably shaped areas of atrophy and hypopigmentation, surrounded by a rim of hyperpigmentation. Note that some lesions occur within the outer ear, quite typical for the diagnosis of discoid lupus erythematosus. All serologic tests were negative and renal function tests were normal.

Treatment: Sun avoidance and sun protection (hat, broad-spectrum, high SPF-rated sunblock) are important. While topical corticosteroids may help, this disorder is most often managed with oral antimalarial agents, such as hydroxychloroquine.

Note: The prognosis is quite good for patients with this type of lupus; progressive systemic disease rarely develops.