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This article discusses a study that examined the relationship between discoid lupus erythematosus (DLE) and various demographic and health factors. The researchers analyzed data from the All of Us Research Program and found that DLE patients had higher odds of having concurrent diagnoses in various domains, including cardiovascular, autoimmune, endocrine, renal, psychiatric, and dermatologic. The study also found that LGBTQ individuals had a lower prevalence of DLE, suggesting potential social or healthcare barriers. Lower income levels and higher prevalence of insurance were also associated with DLE. The study emphasizes the need for further research to explore these disparities and understand the impact of stress and access to healthcare services. [Extracted from the article]

Background: We aimed to investigate the prevalence of skin disease among patients with systemic lupus erythematosus (SLE) and determine whether LE skin disease had clinical or serologic correlates with SLE. Methods: We reviewed records of 335 patients with SLE (seen at Mayo Clinic, Rochester, Minnesota, USA) and abstracted skin manifestations, fulfilled mucocutaneous SLE criteria, and clinical and serologic parameters. Results: Of the 231 patients with skin manifestations, 57 (24.7%) had LE‐specific conditions, 102 (44.2%) had LE‐nonspecific conditions, and 72 (31.2%) had both. LE skin disease was associated with photosensitivity, anti‐Smith antibodies, and anti‐U1RNP antibodies (all P < 0.001). Patients without LE skin disease more commonly had elevated C‐reactive protein levels (P = 0.01). Patients meeting 2–4 mucocutaneous American College of Rheumatology criteria less commonly had cytopenia (P = 0.004) or anti−double‐stranded DNA antibodies (P = 0.004). No significant associations were observed for systemic involvement (renal, hematologic, neurologic, and arthritis) when comparing patients with or without LE skin involvement. LE skin involvement was not significantly associated with internal SLE disease flare, number of medications, or overall survival. Conclusions: LE skin disease commonly occurs in patients with SLE. The presence of LE skin disease had no mitigating impact on the severity of SLE sequelae, disease flares, number of medications, or overall survival. Plain language summary: Skin manifestations of systemic lupus erythematosus (SLE) are myriad and can have a dramatic impact on patients' lives. Our study at Mayo Clinic, Rochester/Minnesota, USA, investigated the range of skin disease that occurs in patients with SLE and showed that these skin manifestations require as much systemic treatment comparable to those used for other organs affected by SLE in patients without skin findings. Patients with skin manifestations did not have better survival than those without skin manifestations. Our study highlights the important role of dermatologists in the care of patients with SLE and in SLE research. [ABSTRACT FROM AUTHOR]

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Discoid lupus erythematosus (DLE) is a disfigurement disease. The atrophic scar and hair loss of this disease are followed by cosmetic defects and profoundly impact psychological health. Concentrated growth factor (CGF) has been widely adopted in medical cosmetology. Here we report a 36‐year‐old female systemic lupus erythematosus patient with a 5‐year history of alopecia in DLE, who was recommended for CGF therapy and experienced hair regrowth. We suggest that CGF may be an effective cosmetic treatment for DLE. [ABSTRACT FROM AUTHOR]

Lupus erythematosus is an inflammatory, autoimmune disease with multiorgan involvement and frequent skin involvement, mostly in females. Cutaneous lupus erythematosus is classified into several subtypes, with discoid lupus erythematosus being the most common form within chronic cutaneous lupus erythematosus. The following is the case of a previously healthy 38-year-old man with systemic lupus erythematosus and cutaneous involvement due to discoid lupus with an atypical distribution of skin lesions. [ABSTRACT FROM AUTHOR]

This article explores the effectiveness of anifrolumab in treating long-term alopecia caused by discoid lupus erythematosus (DLE). The study focuses on a 27-year-old Japanese woman with systemic lupus erythematosus (SLE) whose alopecia was resistant to conventional treatments. The patient's alopecia improved with anifrolumab, a novel therapeutic agent that inhibits Type I interferon activity. The article suggests that anifrolumab can be considered as an effective treatment option for lupus patients with alopecia due to DLE, even in the chronic refractory stage. Early intervention with anifrolumab is emphasized to prevent irreversible scarring and maintain the patient's quality of life. [Extracted from the article]

Thymic Stromal Lymphopoietin (TSLP) is an important cytokine that invokes early immune responses. TSLP, an IL-7-like cytokine encoded by the TSLP gene, activates JAK1 and JAK2 signaling pathways, stimulating dendritic cells to induce inflammatory Th2 cells. This cytokine is associated with pruritus in various cutaneous disorders, particularly atopic dermatitis. Varying levels of the cytokine TSLP have been demonstrated in studies of different cutaneous disorders. Pharmacological treatment targeting TSLP has been explored recently, particularly in the realm of atopic dermatitis. This review explores the relation of TSLP to cutaneous diseases, highlighting its potential as a biomarker for monitoring disease progression in discoid lupus erythematosus (DLE). The pharmacological therapy involving TSLP is discussed, along with the potential role of TSLP promotion in the treatment of alopecia areata. This overview examines the background, structure, and functions of TSLP, with a focus on its association with cutaneous disorders and a special focus on the impact of the atopic march. [ABSTRACT FROM AUTHOR]

An 11‐year‐old male Golden Retriever was presented for consultation due to a chronic progressive lesion on the nose that had started a year before. The majority of the nasal mucosa was affected, with the disruption of the normal architecture, pigment atrophy and abundant peeling on the rostral plane. Histopathology revealed a band of lichenoid infiltrate at the interface and vacuolation of the cells in the basal layer consistent with a diagnosis of canine discoid lupus erythematosus. [ABSTRACT FROM AUTHOR]

Dermatoscopic patterns of discoid lupus erythematosus (DLE) have recently been described in the literature. A temporal correlation of certain dermatoscopic features has also been proposed. There is sparse literature on dermatoscopic features seen in Indian/Asian patients with DLE and the correlation of these features with the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) score. A few of the patients of DLE coming to the dermatology outpatient department of our center in South India were evaluated by dermoscopy. Demographic details, duration of illness, location of plaques, and the CLASI scores were collected. A total of 26 plaques from 12 patients were evaluated by dermoscopy. Hair follicle effacement (n = 20) was the most common feature, followed by patchy pigmentation (n = 18), telangiectasia (n = 13), perifollicular pigmentation (n = 13), and perifollicular scaling (n = 10). There was a statistically significant difference in disease activity (CLASI) in patients with perifollicular scale and telangiectasia compared to patients without the above features. There was a significant difference in the duration of disease among patients with and without follicular red dots.

Discoid (DLE) and systemic lupus erythematosus (SLE) are chronic inflammatory diseases of the connective tissue. Along with pathogenetic features, they have common characteristics. Immune disorders and oxidative stress are involved in pathogenesis of DLE and SLE. Development of oxidative stress is closely associated with the activation of xanthine oxidoreductase (XOR) enzyme system.Aim of the study was to reveal the features of XOR activities profiles in blood of DLE and systemic lupus erythematosus (SLE) patients.Material and methods. 31 patients with DLE, 56 patients with SLE, 35 apparently healthy individuals were enrolled in study. The activities of two convertible forms of XOR (xanthine dehydrogenase (XDG; EC 1.17.1.4) and xanthine oxidase (XO; EC 1.17.3.2)) were measured in plasma, lysed WBC and lysed RBC. The level of uric acid (UA) was determined in plasma.Results and discussion. In contrast to the control, XO activity was higher and XDG activity was lower in plasma of DLE patients; activities of both XOR forms were decreased in lysed lymphocytes. Activity of XO was lower in plasma, XO and XDG activities were higher in lysed lymphocytes in DLE regardless of the SLE activity. XDG activity in plasma of and XO activity in lysed erythrocytes DLE patients was lower than in low activity SLE, but higher than in the subgroup with moderate and high disease activity. XDG activity of lysed erythrocytes in DLE was higher than in patients with low and moderate SLE activities, but lower than in patients with high diseases activity. Uric acid content in plasma of DLE patients was not differ from the control values, its level was increased at II and III degrees of SLE activity.Conclusions. Changes in XOR activity in plasma and lysed WBC in DLE and SLE are unidirectional, but are more pronounced in the systemic form of the disease. Thus, DLE and SLE are characterized by some common changes in XOR activity, at the same time, XOR blood profiles have distinctive features, which are characteristic for nosology.

Background: Polymorphous light eruption (PMLE) is a photodermatosis or a type of skin condition induced by exposure to sunlight, which triggers an immunological reaction. It consists of a polymorphic rash that appears upon exposure to the sun and some people regard it as a type of 'sun allergy'. It occurs in all races, with a predilection for females. Pinpoint papular polymorphous light eruption (PP-PMLE) has been reported in Afro-Americans with a skin phototype four (IV) to six (VI), in whom PMLE expresses itself in the form of pinpoint papules. The papules are 1-2 mm in size and are located in the typical distribution of other variants of PMLE. Methods: A case of pinpoint PMLE in a 51-year-old human immunodeficiency virus (HIV) positive patient with resolved discoid lupus erythematosus (DLE) is reviewed retrospectively. The laboratory work-up consisted of a skin biopsy and a blood sample for antinuclear antibodies (ANA). The diagnosis of PP-PMLE was based on the history, clinical examination and histopathology. Results: The case is an HIV-positive female with PP-PMLE with resolved DLE. Skin examination showed pinpoint hypopigmented flat papules on the lateral aspects of the neck, extensor forearms and the anterior aspects of the lower legs (Figures 1-3). The lesions were scanty on the face. The size ranged from 1 mm to 2 mm. The histopathology confirmed PP-PMLE. She responded well to topical steroids, sun avoidance and sunscreen. Conclusion: PP-PMLE is not uncommon and can be missed or be mistaken for other skin diseases. To date, the researchers have not come across any literature on PP-PMLE in Africans, with most cases having been reported in Afro-Americans. [ABSTRACT FROM AUTHOR]

BackgroundThe incidence of systemic lupus in children with discoid lupus is unknown.ObjectiveThis study assessed the baseline characteristics of patients with pediatric discoid lupus erythematosus (pDLE).MethodsMedical records at 17 sites were reviewed for pediatric dermatology and rheumatology patients with discoid lupus erythematosus. The inclusion criteria were clinical and/or histopathologic diagnosis of discoid lupus erythematosus with an age at onset of 1500 charts reviewed, 438 patients met the inclusion criteria. The cohort was predominantly female (72%) and racially/ethnically diverse. A diagnosis of SLE at the baseline visit (pDLE + SLE) was rendered in 162 (37%) patients using the American College of Rheumatology and in 181 (41%) patients using the Systemic Lupus International Collaborating Clinics criteria. Patients with pDLE + SLE were older at the time of rash onset (median, 12.9 vs 8.9 years; P

Discoid lupus erythematosus (DLE) is a common autoimmune skin disease in dogs. Conventional treatments, such as corticosteroids, can be effective but often have side effects. This case report presents a successful use of cannabinoid therapy (CT) in a dog with DLE resistant to conventional treatment. A 2-year-old mixed-breed dog with a history of DLE presented with worsening lesions despite treatment with corticosteroids and other medications. Liver enzymes levels were elevated, indicating corticosteroid-induced side effects. CT with a CBD-rich full spectrum Cannabis oil was initiated. The dosage was gradually adjusted until the minimum effective dose was found. Within a few weeks of starting CT, the dog showed significant improvement in skin lesions and in liver enzymes levels. After 1 year, the dog remains clinically stable on a low dose of full-spectrum CBD-rich oil. No evidence of DLE recurrence was observed. This case suggests that CT may be a viable alternative or complementary therapy for DLE in dogs, particularly for those experiencing adverse effects from conventional treatments. Further research is warranted to confirm the efficacy and safety of CT for DLE management in dogs. [ABSTRACT FROM AUTHOR]

Discoid lupus erythematosus (DLE) is a chronic autoimmune skin disorder characterized by inflammatory skin lesions. Patients with DLE often exhibit photosensitivity, scarring, and a higher susceptibility to skin cancers. This systematic review aims to comprehensively evaluate the existing literature to better understand the relationship between DLE and cutaneous squamous cell carcinoma (cSCC). A systematic search of major medical databases was conducted to identify relevant studies published between 1978 and 2023. Studies were included if they explored the association between DLE and cSCC and reported epidemiological data, clinical features and outcomes. Evidence shows a correlation between DLE and squamous cell carcinoma. The study aimed to find literature about DLE and squamous cell carcinoma (SCC) and analyse potential risk factors. Healthcare providers should be aware of the increased cancer risk in DLE patients, emphasizing the importance of regular skin examinations and sun protection. [ABSTRACT FROM AUTHOR]

Introduction: Discoid lupus erythematosus (DLE) is a chronic inflammatory disorder of autoimmune origin. It has got both oral and cutaneous manifestations. Case presentation: We present here one case of disseminated DLE with both skin and oral manifestations, along with an exhaustive discussion of the clinical, histological and immunological features to rule out the differential diagnoses. Management: The oral manifestations of lupus erythematosus are very similar to other oral lesions such as lichen planus, lichenoid reactions, GVHD, chronic junctional stomatitis and squamous cell carcinoma. Hence, a biopsy is needed to accurately establish the diagnosis and start appropriate treatment. Conclusion: Definitive diagnosis is arrived based on the information compiled from clinical, histopathological assessments, serum and urine tests, rheumatological evaluation and advanced diagnostic modalities like direct immunofluorescence tests. [ABSTRACT FROM AUTHOR]

Abstract An 11‐year‐old male Golden Retriever was presented for consultation due to a chronic progressive lesion on the nose that had started a year before. The majority of the nasal mucosa was affected, with the disruption of the normal architecture, pigment atrophy and abundant peeling on the rostral plane. Histopathology revealed a band of lichenoid infiltrate at the interface and vacuolation of the cells in the basal layer consistent with a diagnosis of canine discoid lupus erythematosus.

Wenting Hu, Si Zhang, Cuihong Lian Department of Dermatology, Shenzhen Second People’s Hospital, Shenzhen, Guangdong, People’s Republic of ChinaCorrespondence: Cuihong Lian, Department of Dermatology, Shenzhen Second People’s Hospital, No. 3002 Sungang West Road, Shenzhen, Guangdong, People’s Republic of China, Tel +86 755 83366388, Fax +86 755 83003435, Email liancuihong@email.szu.edu.cnAbstract: Cutaneous lupus erythematosus (CLE) is a group of diseases within the spectrum of lupus that primarily manifests with skin lesions. Discoid lupus erythematosus (DLE) is the most common subtype of CLE. Currently, there is no specific medication available for the treatment of CLE. Here, we reported the efficacy and safety of upadacitinib, a JAK1 selective inhibitor, in treating one DLE patient for 28 weeks. Upadacitinib 15mg QD alone improved DLE lesions significantly, while reduction of the drug to 15mg QOD led to a relapse of the skin lesions. Upadacitinib showed favorable safety in this DLE patient in the 28-week period, except for acne, which was controlled by topical application of benzoyl peroxide gel. In this case, we observed rapid and sustained improvement of DLE lesions using upadacitinib with favorable safety, which provided the opportunity to use upadacitinib as an alternative therapy for DLE.Keywords: cutaneous lupus erythematosus, upadacitinib, JAK inhibitor, discoid lupus erythematosus

Discoid lupus erythematosus (DLE) is a common autoimmune skin disease in dogs. Conventional treatments, such as corticosteroids, can be effective but often have side effects. This case report presents a successful use of cannabinoid therapy (CT) in a dog with DLE resistant to conventional treatment. A 2-year-old mixed-breed dog with a history of DLE presented with worsening lesions despite treatment with corticosteroids and other medications. Liver enzymes levels were elevated, indicating corticosteroid-induced side effects. CT with a CBD-rich full spectrum Cannabis oil was initiated. The dosage was gradually adjusted until the minimum effective dose was found. Within a few weeks of starting CT, the dog showed significant improvement in skin lesions and in liver enzymes levels. After 1 year, the dog remains clinically stable on a low dose of full-spectrum CBD-rich oil. No evidence of DLE recurrence was observed. This case suggests that CT may be a viable alternative or complementary therapy for DLE in dogs, particularly for those experiencing adverse effects from conventional treatments. Further research is warranted to confirm the efficacy and safety of CT for DLE management in dogs.

Introduction: Dermoscopic findings are used to diagnose and evaluate disease activity in patients with cutaneous lupus erythematosus (CLE). Objectives: This study aimed to characterize the dermoscopic features of discoid LE (DLE) and LE tumidus (LET) by lesion duration and CLE Disease Area and Severity Index (CLASI) scores and to examine the dermoscopic findings of lesions in different locations in DLE patients. Methods: Dermoscopic findings (follicular features, perifollicular surface, interfollicular features, and vessel pattern) were assessed and lesion duration (≤12 and >12 months) and CLASI scores (grouped as mild or moderate) were calculated. DLE lesion locations were categorized as, non-scalp, scalp and lip. Results: Forty-eight dermoscopic images from 35 DLE and 4 LET patients were analyzed. The most common dermoscopic findings in non-scalp DLE were follicular keratotic plugs (82.8%) and white scales (69%). In scalp DLE (n=9), the most common findings were absent follicular openings (77.8%), white structureless areas (77.8%), and perifollicular scaling (66.7%). All LET patients had pink-white background and linear vessels. Follicular plugs, peripheral pigmentation, and polymorphous vessels were lower in patients with mild CLASI activity than moderate activity (P = 0.036, 0.039, and 0.019, respectively). Fibrotic white dots, honeycomb pigment pattern, and blue-gray dots/globules were lower in those with mild CLASI damage scores than moderate damage (P = 0.010, 0.010, and 0.020, respectively). Peripheral pigmentation was more common in patients with lesion duration ≤12 months, while blue-gray dots/globules were more common with lesion durations >12 months. Conclusions: Certain dermoscopic features may facilitate the differential diagnosis of DLE and LET.

Background: Scarring alopecia is common dermatological disorders in Iraq. The differentiation of the dermatoses among the differential diagnoses of scarring alopecia disorders is difficult especially at earlier stages that needs for new accurate diagnostic tools. Aim of the study is to assess the reliability of trichoscopy for the diagnosis of scalp discoid lupus erythematosus (DLE) and lichen planopilaris (LPP). Objective: This study was to evaluate reliability of trichoscopy in the diagnosis of scalp discoid lupus erthymatosis (DLL) and Lichen planopilaris(LPP). Materials & Methods: A prospective cross-sectional study conducted for forty patients with scarring alopecia in Erbil Dermatology Teaching Centre, over a period of one year. Provisional diagnosis between DLE and LPP were done by two specialist dermatologists in regard to findings of clinical, trichoscopy and histopathology. Results: Clinically, 26 (65%) patients with scarring alopecia were diagnosed as LPP, while 14 (35%) patients were diagnosed as DLE. According to trichoscopy, 24 (60%) patients with scarring alopecia were diagnosed as LPP, while 16 (40%) patients were diagnosed as DLE. Histopathology results identified that 23 (57.5%) patients with scarring alopecia were diagnosed as LPP, while 17 (42.5%) patients were diagnosed as DLE. The validity findings of trichoscopy in comparison to histopathology in diagnosis of LPP were: sensitivity 87%, specificity 76.5%, NPV 81.3%, PPV 81.3% and accuracy 82.5%, while validity findings of trichoscopy in comparison to histopathology in diagnosis of DLE were: sensitivity 76.5%, specificity 87%, NPV 81.3%, PPV 83.3% and accuracy 82.5%. Conclusions: trichoscopy is a valid and reliable diagnostic technique for scarring alopecia disorders and differentiation between scalp LPP and DLE. [ABSTRACT FROM AUTHOR]

Abstract Background Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease characterized by having varying clinical presentation, severity, unpredictable course as well as outcomes. Recent disease-modifying conventional and biologic agents have enhanced rates of attaining both short- and long-term management goals, including minimization of glucocorticoid dose and use. This study was carried out to develop an up-to-date evidence-based, consensus on clinical practice guidelines for treat-to-target management of systemic lupus erythematosus in adults. Results The response rate to the online questionnaires, sent to the expert panel who participated in the three rounds, was 95.5%. At the end of round 3, a total of 14 recommendation sections were proposed for the T2T management of patients with SLE. Agreement with the recommendations (rank 7–9) ranged from 90.9–100%. Consensus was reached (i.e., ≥ 80% of respondents strongly agreed or agreed) on the proposed statements. Conclusion These recommendations provide a consensus on the treat-to-target management of patients with SLE. They provide strategies to reach optimal outcomes in common clinical scenarios, based on a combination of evidence and expert opinion.

The article "Response to 'Systemic correlates of cutaneous manifestations of lupus erythematosus'" explores the relationship between lupus erythematosus (LE) skin disease and systemic lupus erythematosus (SLE). The authors found that LE skin disease commonly occurs in patients with SLE but does not impact the development of severe SLE sequelae, the number of medications needed, or overall survival. The study suggests the importance of closely managing LE skin disease in patients with SLE and calls for further research to better understand the relationship between skin involvement and disease severity. [Extracted from the article]

Cutaneous lupus erythematosus (CLE) is an autoimmune skin disease with various clinical forms, including the subtypes of discoid lupus erythematosus (DLE) and subacute cutaneous lupus erythematosus (SCLE). The altered function of the programmed cell death 1/programmed cell death ligand 1 (PD-1/PD-L1) axis in CLE pathogenesis has been suggested. Here, the soluble forms of PD-1 (sPD-1) and PD-L1 (sPD-L1) were explored in untreated DLE and SCLE. Levels of sPD-1 and sPD-L1 were determined by enzyme-linked immunosorbent assay in serums of 21 DLE, 18 SCLE, 13 systemic lupus erythematosus (SLE) patients and 20 healthy controls (HCs). Differences between patient groups and HCs, and the association between clinical activity of skin symptoms and sPD-1/sPD-L1 levels were analyzed with Mann–Whitney U-test and Spearmann's correlation. Regarding sPD-1 levels, no statistically significant differences were found between DLE and SCLE groups, nor compared to HCs. As for sPD-L1, a significantly lower level was found in the DLE group compared to the SCLE and HC groups (p = 0.027 and p = 0.009, respectively). In SLE, significantly higher sPD-1 was found compared to HCs (p = 0.002). No association between skin symptom activity and sPD-1/sPD-L1 levels was found in CLE. Alterations of the inhibitory effect of sPD-L1 on T-cell activity might elucidate the differences between DLE and SCLE. [ABSTRACT FROM AUTHOR]

Trichoscopy is currently regarded as an essential part of the hair loss consultation. It allows visualization of morphologic structures that are not obvious to the naked eye, including peri- and interfollicular skin surface abnormalities and changes to hair shaft thickness and shape. In this paper, we aim to discuss current knowledge on trichoscopy of the most common forms of scarring and nonscarring alopecias. [ABSTRACT FROM AUTHOR]

Discoid lupus erythematosus (DLE) is an autoimmune disease that represents one of the subtypes of chronic cutaneous lupus erythematosus (CCLE). When located on the scalp, DLE may lead to the development of scarring alopecia. The following study presents the case of a 60-year-old female patient with slowly progressing cicatricial alopecia of a four-year duration. The clinical presentation did not allow for a definite diagnosis. The selection of the most representative site for biopsy was guided by trichoscopy and ultraviolet (UV)-enhanced dermoscopy. The histopathological examination was consistent with the diagnosis of DLE. This paper also discusses the most common dermoscopic findings in active and end-stage DLE. It is postulated, that in all cases of alopecia, picking the spot for biopsy should be guided by trichoscopy. [ABSTRACT FROM AUTHOR]

Discoid lupus erythematosus (DLE) is a chronic autoimmune disease that primarily affects the skin, causing red, scaly patches that may be disfiguring and can cause permanent scarring. This study aimed to investigate the potential clinical and therapeutic applications of heme oxygenase-1 (HMOX1) in the context of DLE. Immunohistochemical staining and bioinformatics analysis were performed on skin biopsy samples from DLE patients to examine the levels of HMOX1 and to correlate with markers of inflammation. Our study revealed a negative correlation between HMOX1 levels and the inflammatory status of DLE lesions, as well as an inverse correlation between HMOX1 levels and the infiltration of M1 macrophages and activated mastocytes. These findings suggest that HMOX1 plays a crucial role in the regulation of inflammation in DLE and could be a potential therapeutic target and biomarker for DLE. [ABSTRACT FROM AUTHOR]

Wasin Saowaluksakul,1 Chutima Seree-aphinan,1 Suthinee Rutnin,1 Kochawan Boonyawat,2 Kumutnart Chanprapaph1 1Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Division of Hematology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Kumutnart Chanprapaph, Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Ratchatewi, Bangkok, 10400, Thailand, Tel +66 2 201 1141, Fax +66 2 201 1211, Email kumutnartp@hotmail.comAbstract: Pemphigus and lupus erythematosus are both B-cell-mediated autoimmune diseases, dependent on autoreactive CD4+ T lymphocytes to modulate autoimmune B-cell response. Many forms of pemphigus have been reported to occur in association with systemic lupus erythematosus (SLE) as well as other autoimmune diseases. However, it remains unclear whether this association occurs because of a shared immunopathogenesis or the coexistence may be coincidental. We hereby present a case report of discoid lupus erythematosus and paraneoplastic pemphigus associated with marginal zone lymphoma in a 54-year-old Thai man who had persistent oral erosions for 1 year together with generalized polymorphic cutaneous eruptions for 2 months. Simultaneous occurrence of paraneoplastic pemphigus and discoid lupus erythematosus without SLE has never been reported in the same individual. Hydroxychloroquine, immunosuppressive agents including prednisolone and azathioprine together with chemotherapy were given to treat these conditions.Keywords: paraneoplastic pemphigus, discoid lupus erythematosus, cutaneous lupus erythematosus, autoimmune bullous disease, non-Hodgkin lymphoma, marginal zone lymphoma