History reveals an unexplained episode of pleurisy 4 years ago What supporting laboratory data are indicated

Answer: This patient clearly has disseminated DLE skin lesions with historical data that raises the possibility of systemic disease. Therefore a full laboratory screen is indicated, including the following:

a. A lesional skin biopsy.

b. Direct immunofluorescence of a lesional skin biopsy.

c. Direct immunofluorescence of a non-sun-exposed nonlesional skin biopsy.

e. Multichemistry panel.

f. Urinalysis with microscopic exam.

h. A complete lupus serology screen.

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