Lupus eritematoso discoide como manifestación inicial de lupus eritematoso sistémico

BACKGROUND: Discoid lupus erythematosus is the most frequent clinical form of chronic cutaneous lupus erythematosus, particularly, only 5-10% of patients with discoid lupus erythematosus develop systemic lupus erythematosus (SLE). CLINICAL CASE: A 46-year-old female patient presented with a history of 3 months of circumscribed progressive hair loss over the right parietal lobe, with associated dry symptoms. An autoimmune profile was performed, showed speckled ANA 1/160, positive rheumatoid factor, and positive anti-Ro antibodies. Histopathological evaluation of the scalp lesion exhibited interface dermatitis. Discoid lupus erythematosus was considered the first manifestation of systemic lupus erythematosus. Patient's cutaneous and systemic symptoms relieved after the administration of systemic immunomodulatory therapy. CONCLUSIONS: Infrequently, discoid lupus erythematosus is associated with systemic lupus erythematosus. It is therefore recommended to regularly perform lab tests in these patients, in some cases, discoid lupus erythematosus can be the initial manifestation of an underlying systemic process.