Necrotizing fasciitis (NF) is an uncommon, but devastating, disease wi
th a significant morbidity and mortality, unchanged in the last severa
l decades. This case report is the first successful management of a pa
tient with NF secondary to discoid lupus erythematosus. A review of th
e literature describes current concepts of etiology, pathophysiology,
diagnosis, and treatment of NF. This case report represents a growing
class of patients at increased risk of NF due to iatrogenic immune com
promise.