Discoid Lupus Erythematosus

Lupus erythematosus is a multisystem disorder that predominantly affects the skin. There are several types of cutaneous lupus. The most common types are acute cutaneous lupus (ACLE), subacute cutaneous lupus (SCLE), and discoid lupus (DLE). Dr. James Gilliam described the most commonly used classification of cutaneous lesions in lupus erythematosus. Gilliam segregated skin lesions into those that are specific and those that are not specifically based upon whether an interface dermatitis was seen on histopathologic examination. Within the category of specific cutaneous lesions, he subdivided these into acute cutaneous lupus erythematosus, subacute cutaneous lupus erythematosus, and chronic cutaneous erythematosus. The most common subset of chronic cutaneous lupus erythematosus is DLE. These patients may or may not report photosensitivity, but lesions are frequently photo distributed and tend to have secondary atrophy or scarring. Most patients with DLE do not have significant systemic disease. DLE can also occur as a manifestation of SLE in approximately 20% of patients. Other less common forms of chronic cutaneous lupus erythematosus include hypertrophic lupus erythematosus, tumid lupus erythematosus, lupus erythematosus panniculitis (LEP or lupus profundus), chilblain LE, oral DLE, as well as DLE lesions on the palms and/or soles.