Mucosal lupus erythematosus: a diagnostic challenge

Abstract

Lupus erythematosus is a chronic autoimmune inflammatory multifactorial condition that may affect multiple organs and is characterized by a variable evolution. One of the most commonly affected sites is the skin, which is often crucial in the recognition of the disease, be it limited or systemic. Cutaneous lupus erythematosus comprises a broad range of skin manifestations. It may affect the oral and the genital mucosa, as well as the lip semimucosa. A case is presented of a female 57-year-old patient of white skin color with erythematosquamous lesions in the perioral region of approximately eight months' evolution. Despite the multiple treatments indicated, improvement was not observed, and thus the patient was admitted for complementary tests, among them skin biopsy, which confirmed the diagnosis of cutaneous lupus erythematosus, mucosal variant. Treatment was started with oral antimalarials and topical corticosteroids, and the patient has had an excellent evolution. Due to its broad clinical heterogeneity, cutaneous lupus erythematosus poses a great challenge to doctors during diagnosis, appropriate classification and selection of the adequate treatment.