Pathology of Discoid Lupus
"There is a butterfly on my nose"
"The lesion usually involves the face and has a "butterfly distribution" on the cheeks and bridge of the nose"
is a chronic inflammatory autoimmune disease with a wide range of
clinical manifestations ranging from an indolent chronic cutaneous
form to a severe potentially life-threatening disease, systemic
Discoid lupus erythematosus is a subphenotype of chronic cutaneous lupus erythematosus, characterised by scaly disk-shaped plaques which may be localised or widespread, occurring predominantly on sun-exposed skin.
Frequently the only manifestation is the "classic butterfly rash".
This is a delicate erythema of the malar area of the face.
The circumscribed, raised, erythematous, scaly, lesions are present on the face, scalp and ears in 70% of patients.
Oral mucosa and hands are sometimes involved.
Eyelid involvement occurs in only 6% of patients, often associated with other cutaneous abnormalities.
Squamous cell carcinoma may occur rarely.
The clinical variants are as follows:
Hypertrophic ; Annular; Papulonodular ; Tumid ; Lymphocytic infiltration of the skin; Linear lesion.
Lupus band test is performed on skin biopsy to confirm the diagnosis.
Direct immunofluorescence of the involved skin shows a broad band of immunoglobulin along the basement membrane.
IgG and IgM are present in 50-90% of cases. Complement 3 is present less frequently.
Copyright © 2019 histopathology-india.net