Lupus Site - a guide for lupus patients and their families

Chronic cutaneous lupus erythematosus, also known as Discoid lupus (DLE) - about 15% of all lupus patients are classified as having DLE, but patients with SCLE or SLE may also have discoid lesions.

It is diagnosed when a patient with a discoid lupus rash (confirmed by skin biopsy) does not fulfill the ACR criteria for SLE.

15 to 30% of all SLE patients have DLE lesions.

5 - 10% of all SLE patients will have DLE as their presenting complaint.

DLE occurs most commonly between the ages of 20 and 40.

The female to male ratio is about 3:2, as opposed to SLE where the ratio is 9:1.

The DLE lesion is usually raised or flat, red, with well-defined borders, they may itch.

DLE is often scarring, and in larger lesions (smaller lesions grow together to make these) can be very disfiguring.

Sun-exposed areas are most often affected: the face, the ears, the scalp, the 'V' of the neck, and the top-side of the forearm.

Discoid lupus can appear similar to other skin lesions, e.g. rosacea, fungal infections, sarcoidosis, seborrhea, dermatomyositis.

Aching joints & other constitutional symptoms are found in 10-20% of DLE patients.

'Localised DLE' is a term used to describe discoid lesions appearing only above the neck.

'Generalised DLE' implies lesions above & below the neck. This form has a 10% chance of developing into SLE.

DLE is most commonly treated with antimalarials, topical injections, & in severe cases, corticosteroids.