Discoid lupus erythematosus masquerading as chronic blepharoconjunctivitis.

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.