Discoid lupus erythematosus

QUESTION 25

A 49-year-old African American woman presents to the dermatology clinic with an area of hypopigmentation on the left ear that has become progressively painful. She does not have any other areas of involvement and denies a history of trauma to the area. She also notes a history of patchy hair loss and arthritis of her ankles. Recent urine studies show incidental finding of proteinuria. In her family history, her mother suffers from hypertension, cardiovascular disease and end-stage renal disease. On examination, there is a hypopigmented patch on the left ear with evidence of scaling, central atrophy and mild hyperpigmentation at the periphery (25).