Discoid Lupus Erythematosus Presenting as Upper Eyelid Edema and Erythema

  • Abbas Darjani Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran.
  • Rana Rafiei Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran.
  • Alireza Mesbah Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran.
  • Razieh Golmohammadi Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran.
  • Behnam Rafiee Department of Pathology, NYU Winthrop Hospital, New York, USA.
  • Mehriar Movaseghi Department of Dermatology, Skin Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Keywords: Discoid lupus erythematosus, Eyelid, Edema, Erythema

Abstract

Discoid Lupus Erythematosus (DLE) is an autoimmune disorder that usually occurs on sun exposed areas of head and neck. Infrequently it could be presented by palpebral involvement and rarely unilateral upper eye lid edema and erythema have been reported as the sole manifestation of DLE. We describe a 38-year-old woman with chronic left upper eye lid edema and erythema from one year ago which was induced by steroid injection for left eyebrow alopecia. Histopathologic and direct immunofluorescent studies were made on palpebral skin tissue and confirmed DLE diagnosis. Antinuclear antibody (ANA) titer was 1/160 with speckled pattern. She was treated by oral hydroxychloroquine (400 mg daily) with moderate improvement after three months. We should think about DLE in cases with chronic upper eye lid edema and erythema. The aim of this case report is to emphasize that ophthalmologist and dermatologists should be aware of different presentations of DLE in the periorbital area to prevent misdiagnosis.

References

Gupta T, Beaconsfield M, Rose GE, Verity DH. Discoid lupus erythematosus of the periorbita: clinical dilemmas,diagnostic delays. Eye (Lond) 2012; 26:609-12.

Pandhi D, Singal A, Rohtagi J. Eyelid involvement indisseminated chronic cutaneous lupus erythematosus.Indian J Dermatol Venereol Leprol 2006;72:370-2.

Frith P, Burge SM, Millard PR, Wojnarowska F. Externalocular findings in lupus erythematosus: a clinical andimmunopathological study. Br J Ophthalmol1990;74:163-7.

Yaghoobi R, Feily A, Behrooz B, Yaghoobi E,Mokhtarzadeh S. Palpebral involvement as a presentingand sole manifestation of discoid lupuserythematosus.ScientificWorldJournal 2010;10:2130-1.

Braun RP, French LE, Massouyé I, Saurat JH. Periorbitaloedema and erythema as a manifestation of discoid lupuserythematosus. Dermatology 2002;205:194-7.

Serarslan G, Atik E, Sarikaya G. Periorbital edema anderythema: an unusual localization of DLE in a patientwith psoriasis. J Dermatol 2011;38:486-8.

Selva D, Chen CS, James CL, Huilgol SC. Discoid lupuserythematosus presenting as madarosis Am J Ophthalmo2003;136:545-6.

Acharya N, Pineda R, Uy HS, Foster CS. Discoid lupuserythematosus masquerading as chronicblepharoconjunctivitis. Ophthalmology 2005;112:19-2.

Erras S, Benjilali L, Essaadouni L. Periorbital edema asinitial manifestation of chronic cutaneous lupuserythematosus. Pan Afr Med J 2012;12:57.

Arrico L, Abbouda A, Abicca I, Malagola R. Ocularcomplications in cutaneous lupus erythematosus: Asystematic review with a meta-analysis of reported cases.J Ophthalmol 2015;2015:254260.

Published
2017-09-16
How to Cite
1.
Darjani A, Rafiei R, Mesbah A, Golmohammadi R, Rafiee B, Movaseghi M. Discoid Lupus Erythematosus Presenting as Upper Eyelid Edema and Erythema. Acta Med Iran. 55(7):474-476.
Section
Case Report(s)