Lupus profundus: not a benign disease

Lupus profundus is an unusual clinical variant of cutaneous lupus erythemat osus that has previously been described as a benign disease that follows a mild course. This report describes the extent of disease and associated com orbidities in patients with severe lupus profundus and systemic lupus eryth ematosus. Four cases of lupus profundus are reviewed and their associated s ystemic disease complications are highlighted. All four patients fulfilled at least four of the 11 criteria for systemic lupus erythematosus. One pati ent suffered from severe facial disfigurement and Parry-Romberg syndrome. T wo patients developed nonhealing ulcers on the scalp. All four patients had scarring alopecia as well as depressed areas over large areas of their bod y surfaces. All patients were resistant to conservative therapy, and requir ed long-term aggressive therapy. Clinical depression secondary to disfigure ment was a major problem in three patients. Extensive lupus profundus may b e associated with more serious systemic disease and warrants aggressive tre atment early on to prevent permanent disfigurement and its resultant psycho logical consequences.