Macrodistribution: Extensor surfaces of extremities, face, and lateral trunk are regularly involved. Lesions are rare below the waist. Photoaccentuation is a common feature (see Photo 17, Fig. 2).
Annular and polycyclic patterns (see Photo 15).
Indicated Supporting Diagnostic Data
Direct immunofluorescence of involved skin is always indicated. If associated features suggest SLE, positive direct immunofluorescence of nonlesional sun-protected skin supports a diagnosis of SLE.
CBC, multichemistry panel, urinalysis, ESR, complement screen (specifically C3, C4, and CH50), lupus antibody screen, and rheumatoid factor are always indicated.
Anti-Ro (SS-A) and Anti-La (SS-B) antibodies are always indicated. Thirty percent of SCLE cases are ANA negative, but are often positive for Anti-Ro antibodies.
See Therapy in DLE section above.
Common Skin Conditions That May Simulate DLE, SCLE, and SLE
See section on SLE below.
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