Discoid Lupus Erythematosus Involving the Eyelids

Of two patients with discoid lupus erythematosus with eyelid involvement, one, a 42-year-old man, had a one-year history of persistent periorbital edema and a violaceous discoloration as the sole manifestation. Although treatment with corticosteroids and antihistamines failed to produce improvement, the patient had an excellent clinical response to systemic hydroxychloroquine therapy. Histologic examination with immunofluorescent staining demonstrated deposition of immunoglobulins at the dermoepidermal junction. The second patient, a 37-year-old woman, had a hyperpigmented lesion on her forearm as the initial symptom but later developed similar lesions elsewhere, including her lower eyelid. Treatment with hydroxychloroquine again produced an excellent response.