A young woman presents with two red, scaly, dime-sized lesions on her right cheek of 3 months' duration.
1. Laboratory work-up should include a complete blood cell count, urinalysis, serology, ANA and related tests, sedimentation rate and, usually, a biopsy. The blood tests should be normal, but the biopsy of fixed tissue and fresh tissue is rather characteristic of discoid lupus. The fresh tissue shows positive direct immunofluorescence at the dermal-epidermal junction (positive lupus band test). The serum test for ANA is usually negative.
Sig: Apply b.i.d. locally to lesions. Do not use fluorinated corticosteroids creams on the face for long periods of time because atrophy and telangiectasia can develop.
3. Sunscreen cream with a sun protective factor (SPF) of 15 or more.
Sig: Apply to face as sunscreen for protection; reapply frequently and use year round.
Chloroquine and hydroxychloroquine are very effective drugs for this disease. However, because of an irreversible retinitis that has developed in rare patients on long-term therapy, periodic eye examinations usually at 6-month intervals by an ophthalmologist are recommended. Quinacrine can also be used but it does cause a yellow discoloration of skin.
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Rosacea and Eczema are two skin conditions that are fairly commonly found throughout the world. Each of them is characterized by different features, and can be both discomfiting as well as result in undesirable appearance features. In a nutshell, theyre problems that many would want to deal with.