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Background: The cutaneous features of acute cutaneous lupus erythematosus (ACLE) can be confused with other dermatoses. The dermoscopic features of ACLE have rarely been reported. Aims: We aimed to study the dermoscopic features of ACLE, malar rash, and generalized ACLE. Materials and Methods: The dermoscopic features of all biopsy and direct immunofluorescence confirmed ACLE cases were analysed retrospectively between May 2019 and May 2020. Results: A total of 21 patients with skin phototypes III, IV, or V were included in the analysis. A pinkish‐white to reddish‐white homogenous area (94.1%), brown dots, globules and peppering (76.4%), and keratotic follicular plugging (64.7%) were the common dermoscopic features observed in the case of generalized ACLE. Similarly, in the case of malar rash, a pinkish‐white to reddish‐white homogenous area (77.8%) was the most common dermoscopic feature, followed by keratotic follicular plugging (66.7%), scales (44.5%), and brown dots, globules, and peppering (44.5%). In both variants, vascular structures were dominated by linear vessels with or without branching. Conclusions: A multicomponent pattern comprising white scales, homogenous pinkish‐white to the reddish‐white area, brown dots/globules/peppering, keratotic follicular plugging, and linear vessels with or without branching were the common dermoscopic features observed in our study and may indicate the diagnosis of both localized and generalized ACLE. In addition, a paucity of dotted vessels may serve as an additional clue. [ABSTRACT FROM AUTHOR]

All the patients satisfied the SLICC criteria for the diagnosis of SLE. Although the diagnosis of a generalized form of ACLE is usually straightforward, it can rarely pose a diagnostic difficulty as a result of its resemblance to drug rash, viral exanthem, polymorphous light eruption, and photo-exacerbated dermatosis like atopic and seborrheic dermatitis. Dear Editor, Acute cutaneous lupus erythematosus (ACLE) is well known to occur in patients with active systemic lupus erythematosus (SLE). [Extracted from the article]