Discoid lupus erythematosus in an infant

Discoid lupus erythematosus (DLE) is rare in childhood. We report the case of a 15-month-old female infant who presented with erythematous telangectatic lesions and photosensitivity involving the sun-exposed areas. Histological examination confirmed the diagnosis of DLE. Direct immunofluorescence (DIF) on lesional skin showed granular IgM deposits along basement membrane zone. Laboratory tests were normal. External photo-protection and topical corticosteroids lead to complete healing. Summer recurrences that responded to topical corticosteroids were noted but there was no progression to systemic lupus erythematosus. Several authors note the absence of female predominance in children with DLE; prevalence of photosensitivity is controversial. Histological confirmation of DLE is easy and important for diagnosis. DIF is not specific but can be helpful in establishing the diagnosis of DLE. Laboratory tests rarely show low titers of antinuclear antibodies. Treatment is based on sun avoidance and photoprotection. Topical corticosteroids are indicated for active lesions. For resistant cases antimalarials are the treatment of choice. Progression to SLE is probably more frequent in children than in adults.