International Journal of Research in Dermatology | July-September 2018 | Vol 4 | Issue 3 Page 456 International Journal of Research in Dermatology Devaraj Y et al. Int J Res Dermatol. 2018 Aug;4(3):456-459 http://www.ijord.com Case Report Discoid lupus erythematosus in acro-orificial vitiligo Yogesh Devaraj*, Belagola Dasegowda Sathyanarayana, Mukunda Ranga Swaroop, Sowmya Shree H., Mithila Ravindranath, Avik Ghosh INTRODUCTION Discoid lupus erythematosus (DLE) is an autoimmune disease characterized by atrophic and discoid plaques over sun-exposed areas of skin and is the most common form of chronic cutaneous lupus erythematosus. Vitiligo is an auto immune disease resulting from progressive loss of melanocytes presenting as depigmented or achromic milky white sharply demarcated macules often associated with leukotrichia. 1 Vitiligo being an autoimmune disease, is known to be associated with other autoimmune conditions such as thyroid disease, diabetes mellitus, and alopecia areata. 2 However coexistence of DLE and vitiligo has been reported uncommonly. We report a case of a 60-year-old lady who developed DLE lesions over pre-existing vitiligo lesions. CASE REPORT A 60-year-old lady presented with white lesions on legs, which started two years ago and then progressed gradually to involve both the palms, soles, nipple, areola, lips and peri-oral areas over a period of one year. Six month ago, patient developed raised scaly lesions over the vertex of scalp and on the whitish patch around the mouth. Patient subsequently developed scaling on the lips and erosions in the oral cavity. Lesions on the scalp and perioral region were associated with burning sensation on exposure to sunlight. There was no history of multiple joint pain, fever, thyroid dysfunction or diabetes mellitus. Patient is hypertensive since one year and on regular treatment. There was no history of vitiligo, collagen vascular disease, diabetes mellitus and thyroid disorder in the family. On examination, multiple depigmented patches were present over the lips, peri oral areas (Figure 1), right nipple, left mammary region involving nipple areola complex, right loin, antero-lateral aspect of both the legs and plantar aspect of both feet. There were few depigmented macules on the dorsum of both feet. Depigmented macules were also present over the extensor aspect of both forearm and proximal nail folds of great toes bilaterally. A single erythematous plaque with adherent scales was present over the vertex of scalp. Erythematous plaques with adherent scales were also ABSTRACT Discoid lupus erythematosus (DLE) is an autoimmune disease characterized by atrophic and discoid plaques over sun-exposed areas of skin and is the most common form of chronic cutaneous lupus erythematosus. Vitiligo is also an autoimmune disease known to be associated with other autoimmune conditions. However coexistence of DLE and vitiligo has been reported uncommonly. We report a case of a 60-year-old lady who developed DLE lesions over pre- existing vitiligo lesions. Keywords: Discoid lupus erythematosus, Vitiligo, Autoimmune, Co-existence Department of Dermatology, Adichunchanagiri Institute of Medical Sciences, Mandya, Karnataka, India Received: 30 May 2018 Revised: 06 July 2018 Accepted: 09 July 2018 *Correspondence: Dr. Yogesh Devaraj, E-mail: yogeshdevaraj86@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/issn.2455-4529.IntJResDermatol20183178