Discoid lupus erythematosus lesions developed on lupus erythematosus profundus nodules

We describe this case of LEP for its unusual way of presentation. It first appeared with a LEP pattern, followed by a typical DLE of the skin, overlying the nodules only. Moreover, our histologic findings showed the typical pattern of lymphocytic lobular panniculitis, with hyaline necrosis of fat, the lymphoid nodule, and even the lymphocytic nuclear "dust." The epidermal changes, with the liquefaction degeneration of the basal cell layer, a moderate follicular hyperkeratosis, and a perivascular and periappendeal lymphocytic infiltrate, were also observed in the abdominal lesion that developed last without clinically evident DLE.