The Role of Dermoscopy in Assessment of the Activity and Scarring Response in Discoid Lupus Erythematosus

The diagnosis of Discoid Lupus Erythematosus (DLE) is usually made by clinical examination and by histopathology. Recently, dermoscopy has become an integral part in diagnoses of many inflammatory disorders and one of these is DLE.

This research emphasizes the utility of dermoscopy in the assessing lesions of DLE from the point of activity of the disease.

Thirty-one patients diagnosed with DLE were included in this study. The total number of examined lesions was 125 lesions. All of the lesions were assessed by dermoscopy at different stages of the activity of the diseases.

The dermoscopic features of DLE vary according to the stage of activity of the disease. There are characteristic dermoscopic features for the lesions of the scalp different from that of the body. In the active and early phase, the most common dermoscopic features were the presence of lesional and perilesional scales, follicular keratotic plugging, telangiectasia, arborized blood vessels, follicular red dots and perifollicular scales. In addition, there are less common dermoscopic features such as pigmentary changes, white rosettes and pinpoint white dots. For active scalp lesions, the follicular plugging and perifollicular scales were more prominent than that of the body DLE lesions. For inactive and late DLE lesions, the most significant dermoscopic changes were perifollicular whitish halos, variable patchy whitish hypopigmented areas, and the presence of white colored structureless areas.

The present study provides new insights into the dermoscopic variability of DLE lesions at different levels of activity.