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April 1963


Arch Dermatol. 1963;87(4):515-521. doi:10.1001/archderm.1963.01590160107023

Diagnosis: Discoid Lupus Erythematosus; Lymphoma? Presented by Dr. Charles Sheard for Dr. Henrietta Abel.

History.—This 60-year-old white male first noted a skin eruption on the face which exacerbated on sun exposure 3 years ago. The diagnosis of discoid lupus erythematosus was made clinically by a dermatologist.

During the past year there has been a 60 lb. weight loss and generalized pruritus with associated enlargement of the neck. Biopsy of a cervical node was read at another hospital as lymphoma, probably Hodgkins. While there one month ago, he had an exacerbation of his facial lesions with development of necrosis of the left infraorbital lesion. Treatment with erythromycin resulted in some improvement in the ulceration.

Examination.—Examination reveals a 6×8 cm. necrotic lesion with black eschar surrounded by profound erythema and edema in the left infraorbital area. There are several well marginated erythematous plaques surmounted by an adherent grayish scale on

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