Sharma Apoorva, K B Meghana, Chatterjee Debajyoti, Kumaran Muthu Sendhil
Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh, IND.
Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, IND.
Cureus. 2025 Mar 9;17(3):e80278. doi: 10.7759/cureus.80278. eCollection 2025 Mar.
Comedonal discoid lupus erythematosus (DLE) is a rare variant of chronic cutaneous lupus erythematosus, often posing diagnostic challenges due to its atypical acneiform presentation. We report a case of a 52-year-old male presenting with alopecia and hypertrophic plaques on the scalp, characterized by follicular plugging, open comedones, and dermatoscopic findings of telangiectasias, scattered pigmentation, and follicular loss. Histopathology revealed hallmark features of DLE, including basal layer liquefaction and perifollicular lymphocytic infiltration. Anti-nuclear antibody testing and systemic lupus erythematosus (SLE) workup were negative. Despite its rarity, early recognition of comedonal DLE is critical to prevent scarring alopecia and ensure timely treatment, which includes strict photoprotection, topical corticosteroids, and systemic hydroxychloroquine. This report underscores the importance of considering DLE in cases of refractory acneiform lesions with atypical clinical features.
粉刺样盘状红斑狼疮（DLE）是慢性皮肤型红斑狼疮的一种罕见变异型，因其不典型的痤疮样表现，常给诊断带来挑战。我们报告一例52岁男性病例，其头皮出现脱发和肥厚性斑块，特征为毛囊堵塞、开放性粉刺，以及皮肤镜检查发现的毛细血管扩张、散在色素沉着和毛囊缺失。组织病理学显示DLE的特征性表现，包括基底层液化和毛囊周围淋巴细胞浸润。抗核抗体检测和系统性红斑狼疮（SLE）检查均为阴性。尽管粉刺样DLE罕见，但早期识别对于预防瘢痕性脱发和确保及时治疗至关重要，治疗包括严格的光防护、外用糖皮质激素和系统性羟氯喹。本报告强调了在具有非典型临床特征的难治性痤疮样皮损病例中考虑DLE的重要性。
