Lip circle or oval erythema

Introduction Discoid lupus erythematosus (DLE) is a skin-mucosal chronic connective tissue disease that is primarily confined to the skin and oral mucosa. Female patients are about twice as many as men. The mucosal lesions of DLE are characterized by elliptical or round plaque erosion, with clear boundaries, concave lesions like discs, and short white stripes around the radial arrangement. The lower lip and lip red mucosa is a good site for DLE. Beginning with dark red papules or plaques, followed by erythema-like lesions, flaky erosion, about 0.5cm in diameter, disc-shaped in the center of the fovea, surrounded by redness or visible telangiectasia, radially arranged around the blush White short stripes.

Cause

The cause of discoid lupus erythematosus is unknown, and it is considered that an autoimmune disease may be related to genetic factors and various stimuli.

1. Genetic factors: Some patients can find a family history and are confirmed by studies on human leukocyte antigen (HLA).

2. Stimulating factors: mostly induced factors, including sun exposure, infection (such as virus, tuberculosis, streptococcus or lesions), endocrine disorders, cold irritation, mental stress, drugs (such as hydralazine).

an examination

Related inspection

Leukocyte antigen (HLA)

Mucosal lesions occur under the lips, red lips, round or oval erythema, slightly depressed in the center, dark red edges, and white radial pattern around the lesion. Lip lesions often exceed the red and red edges of the lips and affect the skin, and the skin boundaries are blurred. There is hyperpigmentation or hypopigmentation around the lesion. Skin lesions occur on the head and face and are characterized by scales, telangiectasia, follicular keratin plugs, pigmentation and/or hypopigmentation and scar formation. The "butterfly spot" around the nose is a typical expression.

Differential diagnosis

Discoid lupus erythematosus should be differentiated from the following diseases:

1. Chronic cheilitis: Chronic cheilitis, especially chronic erosive cheilitis also occurs in the lower lip, which is easily confused with discoid lupus erythematosus in the red part of the lip. DLE can be more than the red edge of the lip in the red part of the lip, surrounded by white Radial fence pattern. Chronic cheilitis sometimes has white lines, but it is not arranged radially, and the lesion does not exceed the red edge of the lips. DLE has skin damage, located in the head and face, upper limbs, chest, neck, lesions are erythema, hair follicle horny plug, scales, pigmentation or pigmentation, telangiectasia, atrophy, etc., and cheilitis without skin damage DLE pathology It is atrophy of the acanthosis, liquefaction and degeneration of the basal layer, and infiltration of inflammatory cells in the deep and blood. Immunofluorescence showed that DLE had a fluorescent band in the basal layer.

2. Lichen planus: OLP skin lesions are symmetrical, occurring in the extremities or torso of the extremities. They are light purple polygonal flat papules, hair follicle holes are dilated, scales are covered, and sometimes scaly ground has horny plugs. In the oral mucosa, the lesion is round or elliptical, the center is thin and thin, surrounded by a white radial pattern, and the red part of the lip often exceeds the red edge of the lip.

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