Histopathological Granuloma Formation in a Subacute Cutaneous Lupus Erythematosus Patient

Introduction: Subacute cutaneous lupus erythematosus (SCLE) is one of the cutaneous lupus erythematous subtypes. Being an autoimmune condition in nature, its diagnosis requires compatible clinical presentation with histopathological findings. Objective: To present a subacute cutaneous lupus erythematosus with granuloma formation. Case Report: A 56- year-old woman presented with longstanding red plaques on her face, trunk, and extremities. Two skin biopsies were performed during two different visits. The results showed tuberculoid leprosy and multiple granuloma annulare. She was treated accordingly for years with no improvement in her condition. Later, the third skin biopsy with CD123 immunohistochemical stain was done. The result was most consistent with cutaneous lupus erythematosus. Together with her clinical findings, she was finally diagnosed with SCLE. Her rashes resolved after being treated with hydroxychloroquine and topical steroid. Conclusion: The diagnosis of SCLE must be made based on both clinical presentations and histopathological findings.