DLE
- SLE risk 5-10% with localized DLE
- 15-30% with generalized DLE
- Photosensitive > non-sun exposed sites
- Favors face, scalp, ears, upper trunk, hands
- Mucosa: hard palate >lips, other mucosa
- Localized (above neck) vs generalized (above + below neck)
- Disfiguring (scarring+ dyspigmentation) ± scarring alopecia
- Follicular plugging and hyperkeratosis (“carpet tack sign” on dermoscopy)
- Hypertrophic (risk of SCC)
- Localized
- Generalized
- LP-DLE overlap
- Profunda
- Mucosal
- Linear
- Vacuolar alteration of basal layer, apoptotic keratinocytes, hyperkeratosis, follicular plugging, basement membrane thickening, pilosebaceous atrophy
- Lymphocytic infiltrate in upper and lower dermis ± subcutis + periadnexal
- ± Epidermal atrophy, ± dermal edema and fibrosis
- Dermal mucin
- Tinea faciei/capitis/corporis
- Pityriasis versicolor
- Lichen planus
- Granuloma faciale
- Sarcoidosis
- Lupus vulgaris
