Histopathological Review on Discoid Lupus Erythematous Mimicking Granuloma Faciale


  • Putti Fatiharani Dewi RSUD Dr. Moewardi, Central Java, Indonesia
  • Fiska Rosita RSUD Dr. Moewardi, Central Java, Indonesia
  • Triasari Oktavriana RSUD Dr. Moewardi, Central Java, Indonesia
  • Ambar Mudigdo RSUD Dr. Moewardi, Central Java, Indonesia




Discoid lupus erythematosus, Granuloma faciale, Histopathology


Discoid lupus erythematosus is the most common forms of chronic cutaneous lupus erythematosus. It is characterized by clinical manifestations of erythematous macules, papules, or plaques with a coin-like shape and the face is the most common predilection site. Clinical features often resemble granuloma faciale. This case report aimed to distinguish discoid lesions on the face based on the histopathological examination. A 71-year-old male with a few reddish lumps appeared on his face since three months ago. Physical examination showed multiple discrete erythematous plaques with overlying squamous. Hematoxylin and eosin staining on the epidermis demonstrated basket weave type orthokeratosis, basal vacuolar cell degeneration, epidermal atrophy with flat rete ridges, and follicular plugging while in the dermis obtained inflammatory cell infiltrates, especially in periadnexal areas. Histopathological features of DLE are hyperkeratosis, pilosebasea gland atrophy, follicular plugging, basal membrane thickening, and cellular infiltrate in periadnexa or perivascular areas more visible than in other types of CLE. In DLE, no subepidermal gren zone and eosinophil infiltrate were found, like histological features of granuloma faciale. Histopathological examination can be used to establish a diagnosis for discoid lesions on the face, although serology examination remains as the gold standart.


Keywords:  Discoid lupus erythematosus; Granuloma faciale; Histopathology


Lee LA, Werth VP. Lupus Erythematosus. In: Bolognia JL, Jorizzo JL, Schaffer JV, editors. Dermatology. 3rd edition. USA: Elsevier Saunders; 2012: 615-27.

Kuhn A, Landmann A. The classification and diagnosis of cutaneus lupus erythematosus. Journal of Autoimmun. 2014: 1-6.

Uva L, Miguel D, Pinheiro C, Freitas JP, Gomes MM, Filipe P. Cutaneus manifestation of systemic lupus erythematosus. Autoimmune Diseases. 2012: 35-50.

Olivia CC, Marques SA, Ianhez PEC, Marques MEA. Granuloma faciale : clinical, morphological and immunohistochemical aspects in a series of 10 patients. An Bras Dermatol. 2016; 91(6): 803-7.

Patterson JW. The lichenoid reaction pattern (interface dermatitis). In: Patterson JW. Weedon’s Skin Pathology. 4th edition. USA: Elsevier; 2016:63-73.

Jarukitsopa S, Hoganson DD, Crowson CS, Sokumbi O, Davis MD, Michet CJ, dkk. Epidemiology of Systemic Lupus Erythematosus and Cutaneous Lupus in a Predominantly White Population in the United States. Arthritis Care Research. 2015;67(6):817-28.

Fiorentino DF, Sontheimer RD. Cutaneus lupus Erythematosus. In: Gaspari AA, Tyring SK, editors. Clinical and Basic Immunodermatology. USA: Springer; 2008: 703-15.

Costner MI, Sontheimer RD. Lupus Erythematosus. In : Goldsmith LA, Kats SI, Gilchrest BA, Paller AS, Leffel DJ, Wolff K, editors. Fitzpatrick’s Dermatology in General Medicine. 8th edition. New York: Mc Graw Hill; 2012:1909-26.

Haber JS, Merola JF, Werth VP. Classifying discoid lupus erythematosus : background, gaps, and difficulties. International Journal of Women”s Dermatology. 2017; 2(3): 62-6.

Goodfiels MJD, Jones SK, Veale DJ. The connective tissue diseases. In: Burns T, Breathnach S, Cox N, Griffiths S, editors. Rook’s Textbook of Dermatology. 8th edition. London: Willey-Blackwell; 2010:51.1-22.

Karumbaiah KP, Shivakumar S. A Histopathologic study of connective tissue diseases of skin. Indian Journal of Pathology. 2017; 6(2): 393-6.

Winfield H, Jaworsky C. Connective Tissue Diseases. In: Elder DE, Elenitsas R, Rosenbach M, Murphy GE, Rubin AI, Xu X, editor. Lever’s Histopathology of The Skin. 11th edition. USA: Wolters Kluwer; 2010:329-41.

Ceballos FIR, Horn TD. Interface dermatitis. In: Barnhill RL, Crowson AN, Magro CM, Piepkorn MW, editor. Dermatopathology. 3rd edition. USA: Mc Graw Hill; 2010:48-53.




How to Cite

Dewi, P. F., Rosita, F., Oktavriana, T., & Mudigdo, A. (2021). Histopathological Review on Discoid Lupus Erythematous Mimicking Granuloma Faciale. Jurnal Profesi Medika : Jurnal Kedokteran Dan Kesehatan, 15(1). https://doi.org/10.33533/jpm.v15i1.2423