Derick Mussen Preventive Healthcare

Discoid Lupus Erythematosus of the Palms and Soles

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DLE of the palms and soles is a rare occurrence characterized by sharply demarcated erythemas and adherent scaling; the lesions tend to be painful and may become erosive. Atrophy and scarring are the features that allow a distinction from the following:

Palmoplantarpsoriasis has no signs of atrophy. Note that palmoplantar psoriasis is only rarely an isolated finding.

Keratoderma blennorhagicum in patients with Reiter's disease presents with pso-riasiform palmoplantar lesions composed of erythemas, erosions, crusting, and hyperkeratosis. In contrast to DLE, hyperkeratosis and inflammation may be marked and extend over the whole surface of the palms and soles.

Porokeratosis plantaris andpalmaris may be similar to palmoplantar DLE because it presents as relatively small, multiple, sharply demarcated annular lesions with a hyperkeratotic peripheral ridge (cornoid lamella) and central atrophy. Palmoplantar porokeratosis is transmitted as an autosomal-dominant trait.