RT Book, Section A1 Usatine, Richard P. A1 Smith, Mindy A. A1 Chumley, Heidi S. A1 Mayeaux, E.J. SR Print(0) ID 57682396 T1 Chapter 180. Lupus: Systemic and Cutaneous T2 The Color Atlas of Family Medicine, 2e YR 2013 FD 2013 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-176964-8 LK accessmedicine.mhmedical.com/content.aspx?aid=57682396 RD 2024/03/28 AB A 39-year-old black woman presented to the clinic with 2 months of swelling of her upper lip and cheeks with new dark spots on her face (Figure 180-1). An antinuclear antibody (ANA) was positive at a 1:80 dilution. A homogeneous nuclear pattern was present as commonly seen in systemic lupus erythematosus (SLE) and drug-induced lupus. The punch biopsy of a facial lesion was consistent with chronic cutaneous lupus erythematosus (discoid lupus). The remainder of her laboratory tests were normal. The patient's facial lesions did not respond to topical steroids and hence she was started on a short course of systemic steroids. The improvement was seen 3 weeks later (Figure 180-2). Hyperpigmentation remained but erythema, swelling, and pruritus were gone. The patient did not meet criteria for SLE and it is possible to have discoid lupus with a positive ANA. Treatment with hydroxychloroquine was discussed.