History: 4993cc This lady has had these lesions on sunexposed areas for 6 months. She takes Coversyl for hypertension. Clinically I think this is lupus erythematosus probably the subacute type.

Description: Lichenoid change

Comments: Microscopic examination reveals a biopsy of skin with lichenoid change with prominent vacuolar change and Civatte body formation. There is a superficial and mid dermal perivascular and perifollicular infiltrate of lymphocytes and histiocytes. There is mild epidermal hyperplasia and some overlying parakeratosis. The features would slightly favour the discoid type of lupus over subacute lupus.