Figure 1. Cutaneous lupus erythematosus. Left. Localized acute cutaneous lupus erythematosus (malar dermatitis). These lesions are abrupt in onset, frequently appear after exposure to the sun, and are characterized by erythema and edema. The sparing of the nasolabial folds and the absence of discrete papules and pustules help to differentiate this condition from acne rosacea (including glucocorticoid-induced rosacea) [1, 2]. Other skin disorders, such as seborrheic or contact dermatitis, dermatophyte infections, and polymorphous light eruption may also be confused with malar dermatitis. Right. Chronic cutaneous lupus erythematosus (discoid lupus erythematosus) with a malar distribution. Discoid lesions are usually found on the face, scalp, ears, or neck and begin as erythematosus papules or plaques with moderate scaling. As the lesion ages, the scale becomes thick and adherent and the follicular openings become dilated and filled with keratinous debris (follicular plugging). Eventually, pigmentary changes (hypopigmentation in the center and hyperpigmentation at the active border), atrophy, and scarring occur. (Courtesy of Dr. Maria Turner.).

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