Discoid Lupus Erythematosus in a 44-Year-Old Woman

Concern about this flat, tan, atrophic, well-marginated, dime-sized lesion prompted a 44-year-old woman to seek medical advice. The lesion, which was mildly pruritic, had appeared 2 months earlier.

The patient had no significant medical history and reported no other symptoms. An incisional biopsy of the lesion was interpreted by a dermatopathologist as discoid lupus erythematosus.

Robert P. Blereau, MD of Morgan City, La, reports that the complete blood cell count, urinalysis, and erythrocyte sedimentation rate were all normal. Antinuclear antibody and serologic studies yielded negative results.

This patient was reassured that systemic lupus erythematosus is rarely associated with such skin lesions. She was cautioned to avoid sunlight and advised to use a sunscreen. The pruritus may be treated with topical fluorinated corticosteroids, but overuse of these preparations must be avoided.