Lupus Erythematosus Profundus With Multiple Overlying Cutaneous Ulcerations: A Rare Case

    Endang Sutedja, Muhamad Radyn Haryadi Widjaya, Hartati Purbo Dharmadji, Oki Suwarsa, Miranti Pangastuti, Hermin Aminah Usman, Chaerani Pratiwi Firdaus
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    TLDR A patient with a rare form of lupus improved after treatment for skin ulcers and hair loss on the face and scalp.
    Lupus erythematosus profundus (LEP) is a rare form of chronic cutaneous lupus erythematosus, occurring in 1–3% of lupus cases, and ulceration is present in 28% of LEP cases. This case report describes a patient with LEP who presented with multiple cutaneous ulcers and cicatricial alopecia on the right cheek and scalp, without systemic manifestations. Histopathological examination confirmed the diagnosis, showing infiltration of lymphocytes, eosinophils, and plasma cells around adipocytes and blood vessels. Treatment included sunscreen, 2% mupirocin cream, wound dressing with dialkyl carbamoyl chloride (DACC), oral corticosteroids, and hydroxychloroquine. After 3 months, the patient showed clinical improvement with ulcer healing, atrophic scars, and reduced erythema. The case highlights the importance of accurate diagnosis for effective management of LEP with cutaneous ulcerations.
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