Lupus Vulgaris: A New Look at an Old Symptom – The Lupoma Observed with Dermoscopy

Case Reports The lesions were observed on the left earlobe of a 48-year-old man (patient 1), on the nose of a 33-year-old woman (patient 2), and on the eyebrow and scalp of a 65-year-old man (patient 3). All lesions appeared at least 2 years before the first dermatologic consultation. Patient 1 presented with a solitary, succulent, reddish and ill-defined nodule 1.5 cm in diameter adjacent to an area of atrophy on the left earlobe ( fig. 1 A). A clinical differential diagnosis between LV and nodular basal cell carcinoma or squamous cell carcinoma was made. By contrast, the lesions in patients 2 and 3 appeared as erythematous scaly, roundish plaques with accentuated borders, with no central atrophy or scarring ( fig. 1 B–D). In the latter patients, the primary clinical differential diagnosis included seborrheic eczema, discoid lupus, tinea and superficial basal cell carcinoma. Biopsy of all lesions was performed and revealed histopathologic features suggestive of LV. Dermoscopic examination of all lesions revealed fine focused telangiectasias on a typical yellow to golden-colored background. In addition, some milia-like cysts and whitish reticular streaks were observed ( fig. 2 ).