Turan Enver, Sinem Bagci Isin, Turgut Erdemir Asli, Salih Gurel Mehmet
Prof. Enver Turan, MD, Harran University, Faculty of Medicine, Department of Dermatology, 63300-Sanliurfa, Turkey;
Acta Dermatovenerol Croat. 2014;22(2):150-9.
Discoid lupus erythematosus (DLE) is the most common form of chronic cutaneous lupus erythematosus. It tends to heal with scarring, hair loss, and pigmentary changes if treatment is not initiated in the early phase of the disease. Classic DLE lesions are initially red-purple macules, papules, or small plaques that rapidly acquire a hyperkeratotic appearance. Only a minority of patients with DLE progress to develop systemic lupus erythematosus (SLE). A small percentage of patients with SLE have concomitant DLE. However, generalized DLE is more frequently associated with systemic involvement than classic DLE. The diagnosis of DLE is usually based on clinical features, although in some cases histopathological examination may be required to confirm the diagnosis. Standard therapy for cutaneous lupus erythematosus includes broad-spectrum sunscreens, topical and intralesional glucocorticoids, and antimalarial agents. A 63-year-old man presented with erythematous scaly patches that he had on the face for approximately eight months. Although the face was the main affected site, lesions were also noted on the scalp, neck, chest, shoulder, upper arms, and trunk. Histopathological examination verified the diagnosis of DLE. Laboratory examination and consultation with other departments did not reveal any systemic involvement. Imiquimod cream 5% was applied three times a week, every other week. After 24 applications over a period of two months, an almost complete recovery was achieved. Topical imiquimod may be an alternative treatment for generalized DLE.
盘状红斑狼疮（DLE）是慢性皮肤型红斑狼疮最常见的形式。如果在疾病早期未开始治疗，它往往会愈合后留下瘢痕、脱发和色素沉着改变。典型的DLE皮损最初为红紫色斑疹、丘疹或小斑块，很快会出现角化过度外观。只有少数DLE患者会进展为系统性红斑狼疮（SLE）。一小部分SLE患者同时患有DLE。然而，泛发性DLE比典型DLE更常伴有系统性受累。DLE的诊断通常基于临床特征，不过在某些情况下可能需要组织病理学检查来确诊。皮肤型红斑狼疮的标准治疗包括广谱防晒霜、外用和皮损内注射糖皮质激素以及抗疟药。一名63岁男性患者面部出现红斑鳞屑性斑块约8个月。虽然面部是主要受累部位，但头皮、颈部、胸部、肩部、上臂和躯干也有皮损。组织病理学检查确诊为DLE。实验室检查及与其他科室会诊未发现任何系统性受累。每周应用3次5%咪喹莫特乳膏，每隔一周一次。经过两个月24次用药后，几乎完全康复。外用咪喹莫特可能是泛发性DLE的一种替代治疗方法。
