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Cutaneous Lupus — RACP Adult Medicine MCQ

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EasyRheumatologyCutaneous LupusRACP Adult Medicine

A 22-year-old woman presents with a butterfly-shaped erythematous rash across both cheeks sparing the nasolabial folds, worse after sun exposure. She has no systemic symptoms. Skin biopsy shows interface dermatitis with IgG deposition at the dermoepidermal junction. What is the most likely diagnosis?

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Correct answer: C — Acute cutaneous lupus (malar rash)

A butterfly-shaped rash across the malar eminences sparing the nasolabial folds with photosensitivity and interface dermatitis with immune complex deposition is the classic malar rash of acute cutaneous lupus erythematosus. ANA and anti-dsDNA should be checked. Sun protection and hydroxychloroquine are mainstays of treatment.

Reference: ACR/EULAR – 2019 – SLE Classification Criteria