HISTOPATHOLOGIC FINDINGS IN CUTANEOUS LUPUS-ERYTHEMATOSUS

Background and Design: The possible distinction between different type s of cutaneous lupus erythematosus (CLE) based on histologic features has been largely debated. This study describes the histopathologic fea tures of three distinct subsets of CLE: chronic, annular-subacute, and papulosquamous-subacute. Biopsy specimens from 92 patients with CLE w ere examined without the clinical diagnosis being known by the examine rs. Of them, 36 clinically demonstated chronic CLE; 32, annular-subacu te CLE, and 24, papulosquamous-subacute CLE. Results: In chronic CLE, the dermal changes (basement membrane thickening, dermal colloid bodie s, pilosebaceous atrophy, and periappendageal infiltrate) were more fr equent, while in annular-subacute CLE, a more severe vacuolation of th e basal layer and a greater number of epidermal colloid bodies were se en. In addition, pilosebaccous atrophy and more severe epidermal damag e were almost exclusive to chronic CLE and annular-subacute CLE, respe ctively. Conclusions: Although some histologic differences between chr onic and annular-subacute CLE exist, histopathologic diagnosis of the CLE subsets can only be accurately established when pilosebaceous atro phy or necrosis of all epidermal layers is observed.