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Discoid Lupus Erythematosus (Cutaneous DLE)

Most common form of chronic cutaneous lupus with scarring discoid plaques, scaling and pigment change.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dermatoloji department. Book Appointment →

What is Discoid Lupus Erythematosus (Cutaneous DLE)?

Discoid lupus erythematosus (DLE) is the most common form of chronic cutaneous lupus erythematosus, characterized by well-defined erythematous plaques with adherent keratotic scale, follicular plugging, atrophy, and dyspigmentation.

Lesions favor sun-exposed sites: face (especially malar area, ears, scalp), neck, arms and hands. Scalp involvement leads to scarring alopecia. Ultraviolet light, smoking and trauma trigger or worsen disease.

Although mostly skin-limited, 5-10% of localized DLE patients and a higher proportion with widespread DLE develop systemic lupus erythematosus. Skin biopsy with direct immunofluorescence (lupus band test) confirms diagnosis.

Symptoms

Round or oval erythematous plaques with adherent scale
Follicular plugging (carpet-tack appearance)
Central atrophy with peripheral hyperpigmentation
Scarring alopecia of scalp
Disfiguring facial scars and pigment change
Photosensitivity (worsening with sun exposure)
Lesions on ear conchae, lips and oral mucosa

Risk Factors

Female sex (3:1 female-to-male)
Ages 20-40 most common
UV light exposure
Smoking (worsens disease, reduces response to antimalarials)
Trauma (Koebner phenomenon)
African or Hispanic ancestry (higher prevalence)
Family history of lupus or autoimmune disease

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent scaly facial or scalp plaques
  • Patchy hair loss with scarring
  • Worsening with sun exposure
  • New systemic symptoms (joint pain, fatigue, fever)
  • Mouth or lip ulcers persisting >2 weeks
  • Disfiguring scarring
  • Pregnancy planning with DLE

Treatment Methods

01
Strict sun protection and broad-spectrum sunscreen
02
Smoking cessation
03
Topical or intralesional corticosteroids
04
Topical calcineurin inhibitors (tacrolimus, pimecrolimus)
05
Hydroxychloroquine (first-line systemic therapy)
06
Methotrexate, mycophenolate, dapsone for resistant disease
07
Belimumab and rituximab in selected refractory cases

Which Department to Visit?

You can visit our Dermatoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.