DISCOID LUPUS ERYTHEMATOSIS - TREATMENT BY LASER ============================ Concerning co2 laser resurfacing. A patient of mine, 50y/0, female, desires to have laser resurfacing for scars secondary to old discoid lupus lesions on the forehead. She has active systemic disease, on antiinflammatory agents. No active skin lesions, and has had none for many years. Any one in Cyberland have experience with resurfacing such patients? Have you seen lupus lesions develop in areas that were resurfaced? Elliot Puritz MD ---------------- Desiree Ratner and John Skouge published a successful case of dermabrasion in DLE. My personal experience is not so happy. Earlier this year I excised an apparently quiescent DLE scalp scar in a 58 yo wf and it recrudesced at the site of surgery. This was not a disaster, just a treatment failure. DLE can exhibit pathergy. Does anyone know how to predict outcome in cutaneous LE scar treatment? Ratner D Skouge JW Discoid lupus erythematosus scarring and dermabrasion: a case report and discussion. [NO ABSTRACT ONLINE] In: J Am Acad Dermatol (1990 Feb) 22(2 Pt 1):314-6 Rhett Drugge, M.D. ------------------ I have had great success using the 585 nm PDL on active DLE patients. Not only did it get the red out, but it also appeared to render the DLE inactive at the treated sites. I worry a bit about CO2 lasing LE and have opted not to do it when the issue presented itself in the past. Please let me know if you have success. I recently had a patient referred by a plastic surgeon who had had several excisions of DLE lesions that were misread by several pathologists as being SCCs and KAs!! (HMO pathologists without apparant dermpath training). There was terrible koebnerization and scarring. Guy Webster, MD PhD ------------------- From: MHKAY1@aol.com Just a tangential case. A young afro-american woman came to me recently to discuss the dark spots on her face secondary to severe discoid lupus. Her condition wqs stabilized so I tried ND-YAG and after a few treatments at various settings I have reduced her hyperpigmentation at least 80%. I have seen no problem so far. I know this is a different question than using the CO2 lasers. Marty Kay MD ------------ I have had good results in 2 cases of DLE[ in remission ] with the 585nm poused dye laser. Roger Ceilley MD ---------------- I had a patient who developed DLE just in the area where his face was burned several years previously in an industrial accident, and I've seen DLE in association with rosacea. I think DLE can come up in skin which has been irritated or injured, but on the other hand dermabrasion has been used to treat DLE scars. I'd try laser on DLE scars, but explain that a test patch should be done first because it might make the DLE flare up. Aggressive sunscreen and sun protection, together with something like Plaquenil would probably be a good idea for about 6 months post op. KC Smith MD FRCPC ----------------- ------- 4.17.96