History:

A middle aged lady presented with a slightly pruritic, red, scaly butterfly rash involved the face oif six months duration. There were no other associalted skin or systemic manifestations and relavent serological tests were normal. It was difficult to differentiated DLE from rosacea in this case. However, skin biopsy was in favor of DLE and she responded well to on month therapy with oral hydroxychloroquine (200 mg per day) plus topical mometasone cream once daily (see third image).