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Image Number 469 (Discoid lupus erythematosus)


Diagnosis: Discoid lupus erythematosus

Site: Scalp

Sex: F

Age: 35

Type: Clinical

Description: Scarring alopecia

Submitted by: Shahbaz Janjua

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Differential Diagnosis

History: DLE is a chronic and recurrent disorder of unknown etiology that primarily affects sun exposed skin of  the malar prominences, bridge of the nose, scalp, and external auditory canals.   The lesions may be extensive involving the upper trunk and extensor surfaces of  the extremities.  The disease is more common in females during their 30s.  The primary lesion is a small erythematous papule or plaque.  As the lesion progresses, the scale becomes adherent and  pigmentary changes are evident with central hypopigmentation and atrophy and hyperpigmentation at the active border.  Multiple lesions may merge together to form larger plaques.  As the lesions expand, dilatation of the follicular openings occurs with subsequent keratinous plugging.  The lesions heal with atrophy and scarring.  Scalp involvement results in permanent alopecia of the affected areas.

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