Skin, Discoid lupus erythematosus, H&E stain

Lupus is an extremely heterogeneous disease that can affect multiple organs. Chronic cutaneous lupus erythematosus can be further sub-divided into discoid lupus erythematosus (DLE), tumid lupus, and lupus panniculitis. DLE may occur in the absence of systemic disease, or may occur in association with systemic lupus erythematosus (SLE). Interestingly, in this patient, a separate, simultaneous biopsy demonstrated eosinophilic cellulitis (Wells Syndrome). Although these represent distinct diagnoses, a common pathophysiology cannot be excluded in this case (see related content).

Sections show parakeratosis, and heavy perivascular lympho-histiocytic infiltrates, with plasma cells. The basement is thickened, and this can be highlighted by PAS. Hales colloidal iron stain shows mucin accumulation.

This slide shows H&E stain, see related content for colloidal iron and PAS stains.