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  • Discoid lupus erythematosus (DLE)/Chronic cutaneous lupus (CCLE) can occur in all skin types but has a higher incidence and prevalence in Black individuals.

  • In darker skin, it can often present with peripheral dark-brown to violaceus atrophic plaques with central erythema or hypopigmentation. It often also resolves with postinflammatory hyper- or hypopigmentation. This color variation in contrast with baseline pigmentation can be very disfiguring.

  • In lighter skin, it tends to present more with hypopigmented to depigmented pink patches.


FIGURE 43-1.

Dark-black patches and plaques with central erythema on the mid-face of a dark-skinned woman. (From Taylor SC, Kelly AP, Lim HW, et al. Taylor and Kelly’s Dermatology for Skin of Color, 2nd ed. New York, NY: McGraw Hill; 2016, Figure 95-43. Reproduced with permission from Barbara Leppard.)

FIGURE 43-2.

Hypopigmented patches on the face of a Vietnamese woman secondary to DLE. Note the brighter pink patch along the mid-upper cutaneous lip, signifying areas of active disease. (Reproduced with permission from Wolff K, Johnson RA, Saavedra AP, et al. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 8th ed. New York, NY: McGraw Hill; 2017, Figure 13-16.)

FIGURE 43-3.

Black plaques on the face and ear, which also has notable follicular plugging. Along the scalp are visible pink and brown plaques with a periphery of black pigmentation. This is a dark-skinned person with chronic untreated disease. (Reproduced with permission from Kang S, Amagai M, Bruckner AL, et al. Fitzpatrick’s Dermatology, 9th ed. New York, NY: McGraw Hill; 2019, Figure 61-8A.)

FIGURE 43-4.

Depigmented patches with central bright-pink scaly patches on the face, neck, and ear of a lighter-skinned man. (Reproduced with permission from Soutor C, Hordinsky MK. Clinical Dermatology. New York, NY: McGraw Hill; 2013, Figure 21-5.)

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