Question

A 35 year old woman has had erythematous, round, scaling papules for several years. The lesions are 5-10 mm in diameter and show follicular plugging. Although the lesions are generalized in distribution, the highest numbers are on the malar prominences, bridge of the nose, scalp, and external auditory canals. Biopsy of the lesions is consistent with either discoid lupus erythematosus or systemic lupus erythematosus. Which of the following additional findings would most strongly tend to exclude discoid lupus?

1. Alopecia of the scalp
2. Anti-ds DNA
3. Noncontracting scars
4. Positive antinuclear antibody test
5. Sun sensitivity

Answer 1

Based on the information you provided, one of the additional findings that would most strongly tend to exclude discoid lupus erythematosus is the presence of alopecia of the scalp. This is because alopecia (hair loss) is more commonly associated with systemic lupus erythematosus rather than discoid lupus. The other findings you mentioned, such as anti-ds DNA, noncontracting scars, positive antinuclear antibody test, and sun sensitivity, can be seen in both discoid and systemic lupus erythematosus.