Rare cause of periorbital and eyelids lesions: Discoid lupus erythematosus misdiagnosed as allergy

Chomičienė, Anželika; Stankeviciute, Ruta; Malinauskienė, Laura; Grigaitienė, Jūratė; Blažienė, Audra

doi:10.1016/j.anai.2017.09.062

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…There were 13/43 (30.0%) cases with bilateral involvement, including 11/43 (25.6%) cases in which both lower lids were affected, and 2/43 (4.7%) 7,8 cases involved all four eyelids. Thus, it can be seen that the involvement of the isolated right upper eyelid was rare and lower lids, especially both lower lids, were the most commonly affected locations.…”

Section: Discussionmentioning

confidence: 99%

Discoid lupus erythematosus solely involving the eyelids: case report and literature review

Wang

et al. 2021

Int J Dermatology

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Background and Objective The involvement of eyelids occurs in only 5–6% of patients with discoid lupus erythematosus (DLE), commonly with mucocutaneous lesions elsewhere. DLE solely involving the eyelids is relatively rare. This study aimed to describe the clinical features and treatments of all the reported cases of DLE with eyelid involvement as the only symptom. Methods A systematic review was done of all the related literature published both in English and Chinese from May 1, 1984, to March 1, 2020. Only those cases of DLE solely involving eyelids were selected and summarized in two tables. Results (i) DLE solely involving the eyelids is five times more likely to affect females than males. (ii) The majority of cases were presenting with unilateral eyelid involvement. Lower lids, especially both lower lids, were the most commonly affected locations. (iii) An erythematous plaque with scales is the most frequent manifestation. (iv) Approximately 22.9% of the cases had a positive antinuclear antibody (ANA) titer, and the speckled pattern was the most seen. For direct immunofluorescence (DIF), 94.4% of the performed cases showed positive results. (v) More than 85% of these cases showed an excellent response to treatment with oral antimalarials. Conclusion Awareness of this atypical presentation is important to avoid underdiagnosis of DLE solely involving the eyelids. A biopsy for both routine histology and DIF is critical for establishing the diagnosis.

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Section: Discussionmentioning

confidence: 99%

Discoid lupus erythematosus solely involving the eyelids: case report and literature review

Wang

et al. 2021

Int J Dermatology

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“…Delay in diagnosis and treatment may result in irreversible loss of sight. [ 5 ] Lower lid blepharitis is the most common finding, with most reports citing the involvement of unilateral eyelid. [ 6 ] Other ocular manifestations may include proptosis, periorbital edema, madarosis, trichiasis, ectropion, entropion, lid scarring, hypertrophic/verrucous lesions, conjunctivitis, conjunctival scarring, symblepharon, and stromal keratitis.…”

Section: Discussionmentioning

confidence: 99%

Ocular discoid lupus erythematosus: More than what meets the eye

Mohta¹,

Pareek²,

Mehta³

et al. 2023

Indian Dermatol Online J

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Lupus erythematosus is a spectrum that includes auto-immune disorders such as systemic lupus erythematosus (SLE), subacute cutaneous lupus erythematosus (SCLE), and chronic cutaneous lupus erythematosus (CCLE). Discoid lupus erythematosus (DLE) is the most common type of CCLE, and ocular DLE is a rather rare presentation. We report the case of a 42-year-old male patient who had been repeatedly mis-diagnosed and upon detailed dermatological workup was found to possess clinical, dermoscopic, and histopathological features of DLE. Our report focuses on the importance of dermoscopy as a useful point-of-care investigation to avoid delay, and thus related complications. It further suggests how fundus examination could prove helpful in identifying lupus-related fundus changes, and explores how to devise a suitable plan of treatment for such patients.

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Lúpus eritematoso discoide envolvendo apenas as pálpebras: relato de caso e revisão da literatura

Dias,

Ribeiro,

Torres

et al. 2024

Arch. Health

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Introdução: O lúpus eritematoso sistêmico (LES) é uma doença autoimune, crônica, com maior prevalência em mulheres. Uma de suas formas, o lúpus discoide, caracteriza-se por lesões limitadas à pele, eritematosas e recobertas por escamas brancas aderentes, com predomínio em áreas foto expostas. Objetivo: Proporcionar ferramentas eficazes para um bom manejo e individualização dessa condição, visando assim melhorar os resultados clínicos e a qualidade de vida dos pacientes. Materiais e métodos: Para a elaboração deste artigo científico, foi realizada uma revisão extensa da literatura sobre manifestações de lúpus eritematoso discóide nas pálpebras. As fontes consultadas incluem artigos científicos e revisões publicadas nas bases de dados Medline/PubMED, SciELO e Cochrane, no período de 2008 a novembro de 2023. Resultados e discussão: O acometimento isolado de pálpebras é de ocorrência rara, o que torna o diagnóstico desafiador. Condições como blefarite, psoríase e dermatite de contato podem ser confundidas com essa manifestação específica. Diante de lesões palpebrais crônicas refratárias ao tratamento clínico, mesmo na ausência de anormalidades nos exames complementares, deve-se realizar a biópsia incisional para elucidação do caso, e se necessário, o exame de imunofluorescência direta. O diagnóstico precoce é crucial para evitar as cicatrizes e possíveis complicações. O tratamento é complexo, envolvendo o uso de corticoides e antimaláricos como a hidroxicloroquina, e talidomida. O oftalmologista deve estar atento aos diagnósticos diferenciais, favorecendo um tratamento adequado. Considerações finais: Os achados deste estudo reforçam a necessidade de uma abordagem multidisciplinar colaborativa, de maneira a melhorar a qualidade de vida dos pacientes e evitar a progressão da doença.

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Rare cause of periorbital and eyelids lesions: Discoid lupus erythematosus misdiagnosed as allergy

Cited by 3 publications

References 7 publications

Discoid lupus erythematosus solely involving the eyelids: case report and literature review

Discoid lupus erythematosus solely involving the eyelids: case report and literature review

Ocular discoid lupus erythematosus: More than what meets the eye

Lúpus eritematoso discoide envolvendo apenas as pálpebras: relato de caso e revisão da literatura

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