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Discoid Lupus Erythematosus — SCE Dermatology MCQ

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HardConnective Tissue & VasculitisDiscoid Lupus ErythematosusSCE Dermatology

A woman has discoid lupus confined to scalp and pinnae, with scarring alopecia but no constitutional, musculoskeletal, renal or haematological features. Which estimate best describes progression to systemic lupus in localised disease?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Approximately five per cent in localised DLE, rising when disease is widespread

Explanation lettering: E = shown as B · D = shown as C · B = shown as D · C = shown as E

A is correct. BAD patient guidance describes progression from localised discoid lupus to systemic lupus as uncommon, around five per cent. Risk is higher when cutaneous disease is widespread and when clinical or laboratory features suggest systemic involvement. Scalp disease and established scarring are important for preventing permanent alopecia but do not independently establish the larger numerical risks offered. Photosensitivity is common in cutaneous lupus, and postmenopausal onset is not the stated risk modifier. Periodic clinical review and reassessment for systemic symptoms remain necessary.

Reference: BAD discoid lupus erythematosus information: https://www.bad.org.uk/pils/discoid-lupus-erythematosus-dle