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Subacute Cutaneous Lupus Erythematosus

Can you identify these pruritic, annular plaques?

DAVID L. KAPLAN, MD—Series Editor

University of Missouri Kansas City, University of Kansas

David L. Kaplan, MD––Series Editor: Dr Kaplan is clinical assistant professor of dermatology at the University of Missouri Kansas City School of Medicine and at the University of Kansas School of Medicine. He practices adult and pediatric dermatology in Overland Park, Kan.

Volume 53 - Issue 5 - May 2013

 

Dermclinic
A Photo Quiz to Hone Dermatologic Skills 

Since the onset of spring several weeks earlier, pruritic, annular plaques have developed on the sun-exposed areas of a 46-year-old woman’s arms, legs, upper chest, and upper back. Applications of SPF 30 sunscreens have not helped. The patient is otherwise healthy and denies taking prescription or over-the-counter medications.

lupus

What are you looking at here?

A. Polymorphous light eruption.

B. Systemic lupus erythematosus.

C. Subacute cutaneous lupus erythematosus.

D. Discoid lupus erythematosus.

E. Granuloma annulare.

(Answer and discussion on next page)

 lupus

ANSWER—Case 3: Subacute cutaneous lupus erythematosus

A biopsy confirmed the clinical impression of subacute cutaneous lupus erythematosus, C, which usually presents with erythematous papules and plaques that primarily involve the face. Unlike the lesions of discoid lupus erythematosus, these annular, erythematous, scaling plaques heal without scarring. Polymorphous light eruption presents as itchy, small papules and annular plaques without scale. Generally, granuloma annulare is asymptomatic and does not scale.