CASE REPORT Paraneoplastic subacute cutaneous lupus erythematosus associated with cholangiocarcinoma David Jenkins and Tess McPherson Dermatology Department, Churchill Hospital, Oxford University Hospitals NHS Trust, Headington, UK ABSTRACT Subacute cutaneous lupus erythematosus (SCLE) is a dermatosis that occurs in genetically predisposed individuals. The exogenous stimulus that triggers this condition is usually unknown; however, medica- tion is often implicated. Malignancy is a rare cause. We present a case of paraneoplastic SCLE to cholangiocarcinoma and briefly review the features of this interesting entity. Key words: cholangiocarcinoma, cutaneous lupus erythematosus, paraneoplastic, subacute cutane- ous lupus erythematosus. INTRODUCTION Cutaneous eruptions in association with, but not due to direct infiltration of, an underlying tumour have been well described. These are the paraneoplastic dermatoses. With manifestations as diverse as dermatomyositis, acanthosis nigricans and erythema gyratum repens, they cover a broad spectrum of skin pathologies. A lesser known member of this group is paraneoplastic subacute cutaneous lupus erythematosus (p-SCLE). We describe a case of SCLE appearing in a woman with a recent diagnosis of cholangiocarcinoma. CASE REPORT A 38-year-old woman with no personal or family history of skin disease developed a widespread pruritic, scaly, erythematous eruption over a period of 3 months (Figs 1,2). It was in a photo-exposed distribution and on history there was a suggestion of photo-exacerbation. There was no mucous membrane involvement and her scalp and nails were normal. She denied using any medications at the onset of the rash. The patient presented with jaundice 1 month before any sign of her skin eruption and was diagnosed with cholangiocarcinoma based on the results of an endoscopic retrograde cholangiopancreatogram. Imaging revealed Correspondence: Dr David Jenkins, Unit 108, 244 Alison Road, Randwick, NSW 2031, Australia. Email: david.jenkins@sesiahs.health.nsw.gov.au Present address: Dermatology Department, Prince of Wales Hos- pital, Randwick, NSW 2031, Australia. David Jenkins, MBBS. Tess McPherson, MD. Conflict of interest: none Submitted 12 May 2014; accepted 3 August 2014. Abbreviation: SCLE subacute cutaneous lupus erythematosus Figure 1 Symmetrical erythrosquamous eruption on photo- exposed areas. A widespread facial distribution with sparing of the periocular region, nasolabial folds, sub-nasal, sub-labial and sub- mental regions is present. Australasian Journal of Dermatology (2016) 57, e5–e7 doi: 10.1111/ajd.12251 © 2014 The Australasian College of Dermatologists