Abstract ID: 26-211
Widen your vision and look beyond the eyes: extra-ocular clues may enable diagnosis of eyelid lesions.
Author: Yalda Sadeghi-Roulin Base Hospital / Institution: Private Practice
Presentation Type: ePoster Presentation
Purpose
Eyelid involvement in discoid lupus erythematosus (DLE) is uncommon and frequently mimics chronic blepharitis, often resulting in delayed diagnosis and consideration of locally invasive biopsy. We would like to highlight the importance of extending clinical examination beyond the periocular region.
Methods
This is a single-case report, including clinical assessment, slit-lamp examination, dermatologic evaluation and histopathological analysis.
Results
A 48-year-old woman with a history of chronic polyarthritis was referred for evaluation of bilateral lower eyelid margin changes (right>left) evolving over 5 years. Slit lamp examination revealed chronic bilateral posterior blepharitis with cicatricial notching of the right lower eyelid without madarosis. Broader clinical evaluation identified a morphologically similar pre-auricular lesion on the left side. Dermatological assessment was performed, and the pre-auricular lesion was biopsied. Histopathological analysis, supported by direct immunofluorescence, demonstrated deposition of C3, IgG, and IgM along the basement membrane, forming a lupus band test, consistent with discoid lupus erythematosus.
Conclusion
Eyelid involvement in DLE is rare and may present with non-specific clinical features, including chronic blepharitis. Careful inspection beyond the periocular region is essential, as extra-ocular skin lesions may provide diagnostic clues. Biopsy of such lesions enable tissue diagnosis while avoiding the cosmetic and functional risks associated with eyelid biopsy.
The patient was managed conservatively, and her therapy was adjusted by her rheumatologist.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Karla | Chaloupka | University Hospital Zurich |