Neglect leads to extremes: maggots and malignancy in a case of discoid lupus erythematosus

Lupus
N BhariA Srivastava

Abstract

Discoid lupus erythematosus (DLE) is a chronic form of cutaneous lupus erythematosus that runs an indolent course. The rare complications of DLE include scarring, mutilation, non-healing ulceration, cicatricial alopecia and malignancy. DLE progresses to systemic lupus erythematosus (SLE) in around 5% of localized cases and 22% of generalized cases. We report a case of DLE, presenting with a six-month history of ulcerated fungating plaques and small crusted nodules superimposed on DLE plaques over both the forearms. Two weeks prior to the presentation, maggots were also noticed on these plaques. Skin biopsies from these lesions were suggestive of squamous cell carcinoma (SCC) and keratoacanthoma. A wide surgical excision of the tumor followed by partial split-thickness skin grafting was performed with complete healing of the lesions. No recurrence has been noted 18 months from follow-up.

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Citations

Mar 19, 2020·Clinical Case Reports·Seerwan Qaradaghy, Sirwan Hadad
Aug 8, 2021·International Journal of Dermatology·Daniel CuestasMariam Rolon
Apr 24, 2021·Italian Journal of Dermatology and Venereology·Calogero PagliarelloCarlo R Girardelli

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Methods Mentioned

BETA
ELISA
biopsies
biopsy

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Carcinoma, Squamous Cell

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