Discoid lupus erythematosus

Lupus erythematosus is an autoimmune-based inflammatory disease whose manifestations are characterised by different symptoms and severity.

The cutaneous form allows the disease to be further classified into three variants:

  • acute cutaneous lupus erythematosus,
  • subacute cutaneous lupus erythematosus,
  • chronic cutaneous lupus erythematosus (discoid lupus erythematosus or DLE).

Acute lupus almost always involves other organs besides the skin, while subacute lupus and discoid lupus are limited to skin manifestations in most patients.

In particular, discoid lupus erythematosus represents the most common variant and is characterised by specific lesions on the skin that occur mainly on photo-exposed areas, such as the face, scalp and sometimes the torso. 

The pathology appears in the form of ‘discoid’ lesions, i.e. round, reddish, thick and scaly; they are lesions characterised by hyperaesthesia, i.e., they are very sensitive to tactile or thermal stimuli. The evolution of the lesions typically involves extension to the periphery and resolution in the centre, where pale, depressed and atrophic areas form, which subsequently heal.

The mucous membranes (lips, oral cavity, tongue and palate) are affected in less than 5% of patients. The head may also be affected, resulting in hair loss; it is rarely present at the nail level with alteration of the normal shape (onychodystrophy).

DLE predominantly affects women (the gender ratio is 2:1) and is more common in young individuals aged between 20 and 40 years; it tends to be more prevalent in individuals with a dark complexion than in those with a light complexion.

the scientific community’s consensus is that the origin of DLE is multifactorial, with genetic, hormonal and environmental influences. 

Other factors which trigger the pathology or its course include the following: 

  • UV exposure (mainly sun exposure, but also the use of tanning lamps),
  • infections,
  • psychological and physical stress,
  • abrupt changes in ambient temperature.


The referral specialist for discoid lupus erythematosus is the dermatologist. 

There is no definitive cure for this disease, but treatments can control the symptoms and heal the lesions if treated in the early stages of appearance; in the case of advanced lesions, the damage becomes irreparable, which is why early intervention is of paramount importance.

The most appropriate drugs are corticosteroid-based ones, which are able to quickly extinguish inflammation.

Prognosis is variable, but as DLE lesions can be the onset sign of systemic lupus erythematosus (5% of cases), close monitoring of patients is always recommended.

As the disease is related to UV exposure, the main prevention measures are aimed at limiting sun exposure. It is therefore advisable to: 

  • apply sunscreen products suited to one’s complexion in adequate quantities before exposure to the sun; renew their application frequently to maintain protection, and as far as possible, limit prolonged exposure, particularly in the middle of the day
  • limit the use of vertical tanning units/tanning beds.