How to differentiate lupus vulgaris and DLE just on the basis of an image?

It can be difficult to differentiate between lupus vulgaris (LV) and discoid lupus erythematosus (DLE) based solely on an image. Both conditions can present with skin lesions, and there can be overlap in their appearance. However, there are some distinguishing features that can help with the differentiation:

  1. Distribution of skin lesions: DLE usually presents with round or oval-shaped lesions on the face, scalp, and ears, while LV typically involves the trunk and extremities.
  2. Border of skin lesions: DLE lesions have a well-defined border, while LV lesions have a more irregular border.
  3. Presence of scarring: LV often causes scarring, while scarring is rare in DLE.
  4. Skin texture: LV lesions can be smooth or waxy, while DLE lesions often have a rough, scaly texture.
  5. Color: DLE lesions are typically red or pink, while LV lesions can be yellowish-brown or reddish-brown.

It’s important to note that these features are not always present and the diagnosis of LV or DLE should be made by a healthcare professional based on a combination of clinical presentation, medical history, and diagnostic tests such as skin biopsy.