Oral discoid lupus erythematosus. II. Skin lesions and systemic lupus erythematosus in sixty-six patients with 6-year follow-up.

Sixty-six patients with oral discoid lesions and either discoid (DLE) or systemic (SLE) lupus erythematosus were followed during an average period of 6 years (range, 0.1 to 25 years). At time of initial examination, thirty-seven patients (56%) had discoid skin lesions and the remaining 29 (44%) had isolated oral discoid lesions. Among the latter, seven patients developed discoid skin lesions during the observation period. Ten of the sixty-six patients (15%) had SLE at the time of initial examination, and SLE developed in another five (8%) who had DLE initially. In six of fifteen SLE patients the oral discoid lesions were the first manifestation of SLE. Presence of ulceration of the oral discoid lesions at time of initial examination was of predictive value with regard to the presence or development of SLE. It is concluded that patients with oral discoid lesions should be seen at least yearly in order to secure an early diagnosis of eventually developing signs of cutaneous DLE and SLE. Furthermore, no connection was noted between the presence of skin lesions and the development or presence of SLE.