Histopathology of chronic cutaneous lupus erythematosus: reevaluating its diagnostic significance
Akanksha Malik, Vishnu Chaudhary, Zeeba Jairajpuri, Geeti Khullar, Puri Poonam, Shruti SharmaAbstract
Background:
Cutaneous lupus erythematosus (CLE), within the spectrum of lupus erythematosus (LE), is an autoimmune disorder with diverse clinical and histopathological manifestations. Diagnosis primarily relies on clinical assessment and histopathological evaluation, with immunological markers supporting these findings. Among these, clinical examination and histology are the most readily accessible, particularly for patients with financial limitations in resource-constrained settings.
Materials and Methods:
A cross-sectional study was conducted at a tertiary care hospital in India over 16 months. Skin biopsies from 31 consecutive, newly diagnosed patients presenting with clinical features of chronic CLE (cCLE) were analyzed. Demographic data and the spectrum of clinical and histopathological findings were recorded and correlated.
Results:
Localized discoid LE (DLE), disseminated DLE, and lupus panniculitis accounted for 18, 10, and 3 cases, respectively. The face was the most commonly affected site, and annular lesions predominated. Epidermal alterations and colloid bodies were observed in 67.74% and 80.86% of cases, respectively. Periodic acid–Schiff positivity and Alcian blue staining for mucin were observed in 74.19% and 48.39% of cases, respectively.
Conclusion:
Histopathological examination remains a cornerstone of diagnosing cCLE, especially in settings where advanced ancillary testing is limited or unavailable.