REPORT OF A CASE
A 55-year-old woman presented with a four-year history of arthritis of the hands and a cutaneous eruption of the face and scalp that was accompanied by progressive alopecia. She gave a history of Raynaud's phenomenon and photosensitivity. There was no history of serositis, and there were no complaints referable to the renal, cardiac, pulmonary, or central nervous systems. The patient's medical history was notable for hypothyroidism and hypertension.Physical examination of the skin revealed a large area of scarring alopecia present over the crown of the head (Fig 1). Erythematous, telangiectatic, atrophic, scarred plaques with pigment change and scale were present on the forehead and cheeks (Fig 2). There was striking involvement of the concha of both ears, as well as mild palmar erythema and periungual telangiectasia. A biopsy specimen was obtained from a scalp lesion (Figs 3 and 4).Laboratory data obtained over the years