PMC5771737_01
A, TLE near right lateral eye consisting of erythematous and edematous plaques. B, Skin biopsy of tumid lupus lesion shows a superficial and deep perivascular and focally interstitial lymphocytic infiltrate. The areas of pallor correspond to increased dermal mucin. C, Varicella zoster infection in the distribution of cranial nerve V3. (B, Hematoxylin-eosin stain; original magnification: x100.)
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A 50-year-old man with a 4-year history of SLE, diagnosed by fulfilling 1997 American College of Rheumatology criteria (antinuclear antibody positive at 1:1280, positive double-stranded DNA, serositis, thrombocytopenia) presented with a 2- to 3-week history of an enlarging erythematous plaque on his right cheek after acute sun exposure (Fig 1, A). The histologic features were interpreted as most consistent with tumid lupus erythematosus (TLE) (Fig 1, B). The steroid cream was discontinued; however, the paresthesia worsened, and an erythematous rash with vesiculopapules developed on his right cheek and buccal mucosa with sharp demarcation at the midline of his face (Fig 1, C).