Eyelids’ involvement occurs in only 5 to 6% of patients suffering from discoid lupus erythematosus (DLE), commonly with mucocutaneous lesions elsewhere. DLE solely involving the eyelids is relatively rare. This study targeted to describe the clinical features and treatments of all the reported cases of DLE with eyelid involvement as the only symptom. The researchers reviewed a systematic review of all the related literature published in English and Chinese between May 1, 1984, and March 1, 2020. Only those cases of DLE solely involving eyelids were selected and summarized in two tables.

The result showed few outcomes – (i) DLE solely involving the eyelids was five times more likely to affect females than males. (ii) The majority of cases were presented with unilateral eyelid involvement. Lower lids, especially both lower lids, were the most commonly affected locations. (iii) An erythematous plaque with scales is the most frequent manifestation. (iv) Approximately 22.9% of the cases had a positive antinuclear antibody (ANA) titer, and the speckled pattern was the most seen. For direct immunofluorescence (DIF), 94.4% of the performed cases showed positive results. (v) More than 85% of these cases showed an excellent response to treatment with oral antimalarials. The study concluded that this atypical presentation is essential to avoid underdiagnosis of DLE solely involving the eyelids.

Ref: https://onlinelibrary.wiley.com/doi/10.1111/ijd.15397