Bilateral periorbital swelling as the initial presentation of cutaneous lupus erythematosus.

ANA: antinuclear antibody BID: twice a day CLE: cutaneous lupus erythematosus DIL: drug-induced lupus SLE: systemic lupus erythematosus INTRODUCTION Cutaneous lupus erythematosus (CLE), defined as isolated cutaneous lesions without significant systemic involvement, has a reported incidence and prevalence of 4.3 and 73.2 per 100,000, respectively. It occurs more commonly among women with a reported age of onset between the second and fourth decades of life. The 3 more common subtypes of lupus are systemic lupus erythematosus (SLE), subacute cutaneous lupus, and discoid lupus erythematosus. A subset of patients shows atypical clinical manifestations of CLE, which are more rare subtypes and pose a diagnostic and therapeutic challenge. Antimalarial drugs are considered the mainstay of systemic therapy. Because it may take 2 to 3 months to note some improvement, oral or topical steroids are used in conjunction to facilitate response. We report a patient with an atypical presentation of CLE who also responded to hydroxychloroquine and review similar cases in the literature.