A Comedonal Variant of Chronic Cutaneous Lupus Erythematosus: Case Report and Literature Review

August 2019 in “ JAAD case reports ”

Caren Droesch, Cynthia M. Magro

chronic cutaneous lupus erythematosus CCLE discoid lupus erythematosus DLE lymphocyte-mediated interface dermatitis follicular hyperkeratosis antimalarials hydroxychloroquine lupus chloroquine

TLDR Chronic cutaneous lupus erythematosus causes scarring, hair loss, and skin discoloration, especially on sun-exposed areas.

This case report described a 57-year-old African-American woman with a rare comedonal variant of chronic cutaneous lupus erythematosus (CCLE) that was initially misdiagnosed as acne vulgaris. Despite treatment with typical acne medications, her condition did not improve. Biopsies revealed features consistent with discoid lupus erythematosus (DLE), including lymphocyte-mediated interface dermatitis and follicular hyperkeratosis. The literature review identified only 8 previous cases of comedonal CCLE, predominantly affecting young women and often misdiagnosed due to its resemblance to acne. Effective treatments included antimalarials like hydroxychloroquine, highlighting the importance of recognizing this variant to prevent significant morbidity from delayed diagnosis.

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