Discoid lupus erythematosus masquerading as chronic blepharoconjunctivitis

Abstract

Purpose: To recognize discoid lupus erythematosus (DLE) as a treatable cause of chronic blepharoconjunctivitis.

Design: Retrospective observational case series.

Participants: Records of 5 patients with biopsy-proven DLE were reviewed.

Methods: Clinical and pathology records were examined.

Main outcome measures: Patients' clinical and histopathological characteristics and response to treatment were assessed.

Results: Clinical features included meibomian gland dysfunction, blepharitis, chalazia, trichiasis, madarosis, conjunctivitis, chronic eyelid edema, and eyelid plaques. Histopathology showed hyperkeratotic epithelium, degeneration of the basal cell layer, and a perivascular lymphocytic infiltrate. There was delayed diagnosis in all cases, ranging from 4 months to 25 years. All of the patients responded to systemic hydroxychloroquine therapy.

Conclusions: Heightened awareness of eyelid DLE may lead to earlier detection and specific therapy for this chronic disorder.