Microdistribution None

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).

Configuration

Annular and polycyclic patterns (see Photo 15).

Figure 2: Macrodistribution of SCLE.

Indicated Supporting Diagnostic Data

Skin biopsy is always indicated.

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.

Therapy

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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