Scar classification in cutaneous lupus erythematosus: morphological description.
BACKGROUND
Scarring represents the single most debilitating aspect of discoid lupus erythematosus (DLE) in patients with cutaneous lesions alone. Despite this, there have been no studies which have attempted to classify the types of scars seen in this chronic disease.


OBJECTIVE
The aim was to classify the types of scars based on morphological description.


METHODS
Forty-five patients with histologically confirmed DLE were included in the study. In the assessment of the types of scars, the scars were scored initially according to their anatomical localization. Each anatomical area was assessed for the types of scars which occurred in these areas.


RESULTS
Scars in patients with DLE were initially classified morphologically into six types according to the site of the scar and then each type was classified into subtypes according to the morphology of the scar. Scars were seen in the majority of the patients and scarring affected mostly areas including the scalp, other hairy areas such as the eyebrows, nonhairy areas, mucosa, fatty layers of the skin and the nails. This study demonstrated that scars may not only produce textural changes but may also produce pigmentary changes. It is possible that other types of scars may yet occur in DLE but have not so far been detected.


CONCLUSIONS
Early classification and identification of the types of scars in these patients may change management towards more aggressive therapy in those with continued disease activity, and it is possible that different types of scarring require different therapies.
Al-Refu
K
K
Faculty of Medicine, Department of Internal Medicine, Mutah University, Karak, Mutah 61710, Jordan. alrefukhi@yahoo.com
Goodfield
M
M
D001706:Biopsy; D002921:Cicatrix / Q000145:classification / Q000473:pathology*; D005260:Female; D006801:Humans; D008178:Lupus Erythematosus, Cutaneous / Q000145:classification / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012880:Skin Pigmentation