Discoid lupus erythematosus – a case report, diagnostic and therapeutic difficulties
DOI:
https://doi.org/10.20883/jofa.51Keywords:
lupus erythematosus, discoid lupus erythemotosus, squamous cell carcinoma, SCCAbstract
Discoid lupus erythematosus is the most common clinical manifestation of lupus erythematosus. Characteristic features are erythematous plaques with follicular hiperkeratosis, clearly demarcated from surrounding skin, that resolve with atrophy and scarring, leading to significant aesthetic defects. The consequence of involving the scalp is cicatrical alopecia. On the ground of long lasting, untreated lesions squamous cell carcinoma (SCC) may develop. On the other hand SCC remains in the circle of DLE differentiation. We present diagnostic and therapeutic difficulties associated with DLE.
Downloads
References
Blake SC, Daniel BS. Cutaneous lupus erythematosus: A review of the literature. Int J Womens Dermatol. 2019 Jul 31;5(5):320–329.
Gilliam JN, Sontheimer RD (1977) The cutaneous signs of lupus erythematosus. Cont Educ Fam Phys 6:34–70.
Kuhn A, Ruzicka T. Classification of cutaneous lupus erythematosus. In: Cutaneous Lupus Erythematosus. Kuhn A, Lehmann P, Ruzicka T (eds). Springer‑Verlag, Berlin 2004; 53–8.
Woźniacka A, Sysa‑Jędrzejowska A, Reich A, i wsp.: Cutaneous lupus erythematosus. Diagnostic and therapeutic recommendations of the Polish Dermatological Society. Dermatol Rev/Przegl Dermatol 2018;105:244–263.
Petri M, Orbai A‑M, Alarcón GS, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis and rheumatism. 2012;64(8):2677–2686.
Rees F, Doherty M, Grainge MJ, et al. The incidence and prevalence of systemic lupus erythematosus in the UK. 1999–2012. Ann Rheum Dis. 2016;75(1):136–41.
Grönhagen CM, et al. Cutaneous lupus erythematosus and the association with systemic lupus erythematosus: a population‑based cohort of 1088 patients in Sweden. Br J Dermatol. 2011;164(6):1335–1341.
Jarrett P, Thornley S, Scragg R. Ethnic differences in the epidemiology of cutaneous lupus erythematosus in New Zealand. Lupus. 2016;25(13):1497–1502.
Durosaro O, Davis MD, Reed KB, Rohlinger AL. Incidence of cutaneous lupus erythematosus. 1965–2005: a population‑based study. Arch Dermatol. 2009;145(3):249–253.
Petersen MP, Möller S, Bygum A, Voss A, Bliddal M. Epidemiology of cutaneous lupus erythematosus and the associated risk of systemic lupus erythematosus: a nationwide cohort study in Denmark. Lupus. 2018;27(9):1424–1430.
Kuhn, A, Sticherling, M. and Bonsmann, G. (2007), Clinical Manifestations of Cutaneous Lupus Erythematosus. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 5: 1124–1137.
Kuhn A, Aberer E, Bata‑Csörgő Z, et al.: S2k guideline for treatment of cutaneous lupus erythematosus – guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV). J Eur Acad Dermatol Venereol 2017;31:389–404.
Garrett AB. Multiple squamous cell carcinomas in lesions of discoid lupus erythematosus. Cutis. 1985 Oct;36(4):313–4, 316.
Simpson JK, Medina‑Flores R, Deng JS. Squamous cell carcinoma arising in discoid lupus erythematosus lesions of the ears infected with human papillomavirus. Cutis. 2010 Oct;86(4):195–8.
Shapera EA, Kim PD. Squamous Cell Cancer Arising in an African American Male Cheek from Discoid Lupus: A Rare Case and Review of the Literature. Case Rep Surg. 2016;2016:9170424.
Fernandes MS, Girisha BS, Viswanathan N, Sripathi H, Noronha TM. Discoid lupus erythematosus with squamous cell carcinoma: a case report and review of the literature in Indian patients. Lupus. 2015 Dec;24(14):1562–6.
Wang Y, Lipner SR. Retrospective analysis of squamous cell carcinoma associated with ingenol mebutate reported to the US Food and Drug Administration. Dermatol Ther. 2020 Nov;33(6):e14114. doi: 10.1111/dth.14114.
Lallas A, Apalla Z, Argenziano G, Moscarella E, Longo C, Zalaudek I. Clues for differentiating discoid lupus erythematosus from actinic keratosis. J Am Acad Dermatol. 2013 Jul;69(1):e5–6.
Obermoser G, Sontheimer RD, Zelger B. Overview of common, rare and atypical manifestations of cutaneous lupus erythematosus and histopathological correlates. Lupus. 2010;19(9):1050–1070.
Tang, Z, Kang, L, Zhang, Y, Huang, J, Tong, X, Zhou, L, & Zeng, J. (2020). The diagnostic value of in vivo reflectance confocal microscopy in actinic keratosis. Skin Research and Technology.
Włodarkiewicz A, Narbutt J, Adamski Z, et al. Actinic keratosis – state of art. Statement of experts of Polish Dermatological Society. Dermatology Review/Przegląd Dermatologiczny. 2014;101(2):156–167. doi:10.5114/dr.2014.42831.
Zaalberg A, Moradi Tuchayi S, Ameri AH, Ngo KH, Cunningham TJ, Eliane JP, Livneh M, Horn TD, Rosman IS, Musiek A, Anadkat MJ, Demehri S. Chronic Inflammation Promotes Skin Carcinogenesis in Cancer‑Prone Discoid Lupus Erythematosus. J Invest Dermatol. 2019 Jan;139(1):62–70.
Rossi R, Mori M, Lotti T. Actinic keratosis. Int J Dermatol. 2007 Sep;46(9):895–904.