Abstract REPORT OF A CASE A 21-year-old black man presented to the dermatology clinic with a complaint of redness and swelling of the lateral aspect of his right lower eyelid that progressed to the left lower eyelid. These symptoms were exacerbated by exposure to sunlight.Physical examination revealed erythematous plaques with areas of hair loss and scarring of the lower eyelids (Figs 1 and 2). Results of initial laboratory examinations were significant for the following: antinuclear antibody titer, 1:80 (in a speckled pattern), and a normal angiotensin-converting enzyme concentration. The chest roentgenogram was normal.A biopsy specimen of the right lower eyelid was obtained for routine histologic studies (Figs 3 and 4) and direct immunofluorescence (Fig 5).What is your diagnosis? DIAGNOSIS: Discoid lupus erythematosus (DLE). HISTOPATHOLOGIC FINDINGS The biopsy specimen of the right lower eyelid initially revealed mild-to-moderate chronic inflammatory changes with a patchy lymphohistiocytic infiltrate in a perivascular References 1. Huey C, Jakobiec FA, Iwamoto T, et al. Discoid lupus erythematosus of the eyelids . Ophthalmology . 1983;90:1389-1398.Crossref 2. Donzis P, Insler MS, Buntin DM, et al. Discoid lupus erythematosus involving the eyelids . Am J Ophthalmol. 1984;98:32-36.Crossref 3. Sontheimer RD, Rothfield N, Gilliam JN. Lupus erythematosus . In: Fitzpatrick TB, Eisen A, Wolff K, Freedberg I, Austen KF, eds. Dermatology in General Medicine . 3rd ed. New York, NY: McGraw-Hill International Book Co; 1817-1823. 4. Ziv R, Schewach-Millet M, Trau H. Discoid lupus erythematosus of the eyelids . J Am Acad Dermatol. 1986;15:112-113.Crossref 5. Tosti A, Tosti G, Giovannini A. Discoid lupus erythematosus solely involving the eyelids: report of three cases . J Am Acad Dermatol. 1987;16:1259-1260.Crossref 6. Anderson LL, Grimwood RE. Discoid lupus erythematosus manifesting as chronic blepharitis . J Assoc Milit Dermatol. 1989;15:12-15. 7. Callen JP. Therapy of cutaneous lupus erythematosus . Med Clin North Am. 1982;66:795-805.
Archives of Dermatology – American Medical Association
Published: Apr 1, 1993