Background: Discoid Lupus Erythematosus (DLE) is a chronic autoimmune skin disease that primarily affects sun-exposed areas and has a low risk of progression to systemic lupus erythematosus (SLE). It typically presents as erythematous papules or plaques, exhibiting histological features such as vacuolar degeneration and lymphocytic infiltration. This study aimed to analyze the demographic and histological characteristics of DLE patients at Razi Hospital, with a focus on improving disease management and understanding. Methods: A retrospective cross-sectional study was conducted at Razi Hospital in Tehran, examining patients with DLE from 2022 to 2024. Data were collected from hospital records, with primary outcomes including the number of lesions, their sizes, and histopathological findings. Descriptive and comparative statistical analyses were performed using SPSS version 28. Results: Among the 97 patients studied, 64. 95% were female, with an average age of 42. 85 years. Lesions predominantly occurred on the face (62. 89%), with red being the most frequently observed color (45. 36%). Symptoms such as pruritus or burning sensations were reported in 50. 5% of cases. Scalp involvement was noted in 39. 17% of patients, and 23. 71% had a history of systemic disease. The mean duration for lesion development was 56. 84 weeks. Histopathological analysis revealed lymphohistiocytic inflammation in 84. 54% of cases, with epidermal changes significantly affecting the timing of lesion appearance (P = 0. 011). Dermal changes did not demonstrate a significant impact on the timing or number of lesions. Conclusion: The study concluded that DLE lesions predominantly occur on the face and are primarily red in color. Lymphohistiocytic inflammation was identified as the most common histopathological finding, with epidermal changes significantly influencing the onset of lesions.

Kikuchi-Fujimoto disease is an uncommon, benign, autoimmune condition characterized by lymphadenopathy, fever, and neutropenia. It is a self-contained condition of unidentified etiology. A 38-year-old female of Iranian Kurdish origin referred to us with multiple neck swellings, fever, and generalized arthropathy. There was no weight loss and no history of tuberculosis, medication intake, or allergy. Clinical examination revealed bilateral large, mobile, and tendercervical lymphadenopathy. Cardiovascular, respiratory, and neurological examination was normal. The patient had leucopenia and thrombocytopenia. Kikuchi-Fujimoto disease must be considered in the differential diagnosis of a female patient with fever and cervical lymphadenopathy.

Background: Scarring (cicatricial) alopecia represents a complex group of inflammatory disorders, mainly characterized by destruction of the hair follicle unit. Lichen planopilaris (LPP) and discoid lupus erythematosus (DLE) are the two main causes of primary cicatricial alopecia (PCA), both leading to hair follicle destruction and irreversible alopecia. However, they are different in pathogenesis and sometimes are diagnostically challenging.Methods: Twenty-eight formalin-fixed paraffin-embedded (FFPE) specimens of skin biopsies from 17 patients with a clinicopathologic diagnosis of LPP and 11 patients diagnosed as DLE were included. Histopathological study was performed with Haematoxylin and Eosin (H&E)-stained slides; then, immunohistochemical staining (IHC) was performed against CD20, CD3, CD4, and CD8 to evaluate and compare the type and distribution pattern of dermal inflammatory infiltrate.Results: Immunohistochemical findings showed a predominance of T-cells in both groups. CD8+ T-cells were significantly more abundant in LPP (15 cases with 10-50% of infiltration) than DLE (11 cases with <25% of infiltration) with preferential involvement of the perifollicular region (P <0.05). The proportion of CD4+ T-cells in DLE cases was significantly higher than LPP cases (9 cases with 10-50% of infiltration versus 15 cases with 0-10% of infiltration, respectively) (P <0.05) with perivascular and perifollicular distribution.Conclusions: This study supports the usefulness of IHC for CD4 and CD8 in the differential diagnosis of LPP and DLE in problematic cases.

We report phakomatosis pigmentovascularis (PPV)detected in a 40- year old male characterized by the presence of a port-wine stain in the background of aberrant Mongolian spots covering the back, nevus of Ota, ocular melanosis, epidermal nevus and a scaly patch with the diagnosis of discoid lupus erytematosus. These associations have not been reported yet.

Background and aims: Lichen planus (LP) and discoid lupus erythematosus (DLE) are two relatively common mucocutaneous lesions whose clinical and histopathological features overlap in some cases. The present study aimed to distinguish between these two lesions histopathologically in order to treat them more accurately. Methods: In a cross-sectional descriptive-analytical study, 29 and 48 microscopic slides of skin samples of DLE and LP, respectively, were examined in the pathology archive of Al-Zahra hospital of Isfahan from 2008 to 2018. The slides prepared by hematoxylin-eosin staining were examined simultaneously and blindly by three pathologists with a light microscope and compared according to certain histopathological criteria. Then obtained data were analyzed by SPSS version 24 using chi-square, Fisher’, s exact, Mann-Whitney, and t tests (P < 0. 05). Results: Based on the findings, the presence of hyperparakeratosis with superficial hyperorthokeratosis, epithelial atrophy, deep perivascular infiltration, presence of edema in the papillary dermis, presence of plasma cells with lymphohistiocytes in inflammatory infiltration, and presence of mucin in the dermis were significantly higher in DLE than in LP (P < 0. 05). On the other hand, the intensity of lichenoid infiltration, presence of saw tooth hyperplasia of rete ridges, presence of cleft between the epithelium and connective tissue, spongiosis, hyperorthokeratosis alone, and wedge-shaped hypergranulosis were significantly higher in LP than in DLE (P < 0. 05). Conclusion: Perieccrine and perifollicular inflammation, presence of Civatte bodies (CBs), abundance of fibrosis, presence of pale keratinocytes, and presence of pseudoepitheliomatous hyperplasia were not the criteria for differential diagnosis of LP and DLE.