Discoid lupus erythematosus masquerading as chronic blepharoconjunctivitis.

Abstract

To recognize discoid lupus erythematosus (DLE) as a treatable cause of chronic blepharoconjunctivitis. Retrospective observational case series. Records of 5 patients with biopsy-proven DLE were reviewed. Clinical and pathology records were examined. Patients' clinical and histopathological characteristics and response to treatment were assessed. 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. Heightened awareness of eyelid DLE may lead to earlier detection and specific therapy for this chronic disorder.