Discoid lupus erythematosus in a Saudi population: Clinical and histopathological study

Background: We report the clinical and histopathological features of discoid lupus erythematosus (DLE) in a group of Saudi patients, and provide a basic framework for a subsequent larger, prospective study. Methods: DLE patients seen and diagnosed at the Dermatology Clinic of King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, between January 1998 and December 2010 were retrospectively studied. Data included demographics, duration of the disease, precipitating and aggravating factors, clinical type, immunological markers and histopathological findings. Results: Of the 56 DLE patients, females outnumbered males by 1.5:1. Mean age of onset was 36.5 ± 13.7 years and mean duration of the disease was 18.5 ± 24.6 months. Majority of patients (91.1%) had atrophic type. The scalp and face were the commonest sites of involvement. Antinuclear antibodies (ANA) were positive in nine patients (16.1%). Eight (14.3%) were positive for DsDNA. Fifty-two (92.9%) showed dermal infiltration, 38 (67.9%) with periappendigeal infiltrates and 31 (55.4%) with lichenoid reaction and vacuolar degeneration. Fifty-one patients (91.1%) received treatment; 31 (60.8%) had improvement of the lesions whereas six patients (11.8%) progressed to systemic lupus erythematosus (SLE). Progression of the disease was significantlycorrelated with age of onset (p= 0.044) but not to duration of the disease, gender, immunologicalmarkers, histopathological features or treatment.Conclusion: The propensity of some patients progressing to systemic lupus should be given attentionthrough early diagnosis, patient education and appropriate management.