Discoid lupus erythematosus - External and Internal Eye
Discoid rash is one of the 11 diagnostic criteria for systemic lupus erythematosus (SLE), and 20% of patients with SLE will manifest discoid lesions. However, only 5%-10% of patients with DLE demonstrate systemic involvement or will go on to develop SLE. Risk factors for the development of SLE include widespread DLE, arthralgias ⁄ arthritis, nail changes, anemia, leukopenia, an elevated ESR, and a positive test for antinuclear antibodies (ANA).
Lower eyelid involvement occurs in 6% of discoid lupus patients and may present with an associated chronic blepharitis. DLE-associated stromal keratitis has been reported. Periorbital mucinosis of DLE may also present as periorbital edema and erythema.
Squamous cell carcinoma may rarely develop in chronic DLE scars, especially in sun-exposed areas.
Related topics: Tumid lupus erythematosus, Lupus panniculitis, Subacute cutaneous lupus erythematosus, Drug-induced lupus erythematosus
L93.0 – Discoid lupus erythematosus
200938002 – Discoid lupus erythematosus
- In cases with periorbital edema / erythema, consider hypothyroidism and autoimmune thyroiditis.
- Granuloma faciale
- Lichen planus
- DLE lesions have been associated with chronic granulomatous disease. In familial cases, check for complement deficiency.
- Other forms of scarring alopecia, such as tinea capitis, lichen planopilaris, and central centrifugal cicatricial alopecia
- Subacute cutaneous lupus erythematosus
- A single plaque in a lighter skin phototype may be mistaken for squamous cell cancer or squamous cell cancer in situ.