How accurate is a skin biopsy for lupus

How Accurate Are Skin Biopsies? - MedicineNe

Called a skin biopsy, this procedure is often enough to determine whether the rash or other skin problem is cutaneous (medical term for skin) lupus. Your dermatologist may also ask you about the medicines that you take. Some medicines can cause a type of lupus called drug-induced lupus While most people with SYSTEMIC lupus have positive ANA, in a small subtype called Ro-lupus, ANA stays negative. The test is hard to perform, so different labs can get different results. And in *skin-only* lupus, ANA stays negative, as do the more specific subtype tests A biopsy procedure involves removal of a small bit of tissue that the doctor then examines under a microscope. Almost any tissue can be biopsied. The skin and kidney are the most common sites biopsied in someone who may have lupus. The results of the biopsy can show the amount of inflammation and any damage being done to the tissue A skin biopsy is a procedure to remove cells or skin samples from your body for laboratory examination. A doctor uses a skin biopsy to diagnose skin conditions and remove abnormal tissue. The three main types of skin biopsies are: Shave biopsy. A doctor uses a tool similar to a razor to remove a small section of the top layers of skin.

This is very interesting as I am still waiting to see a dermatologist and have been diagnosed with a vasculitis syndrome without having a skin biopsy, which is not best practice. If you are already on medications, such as hydroxychloroquine, when you have a skin biopsy, will this prejudice an accurate test result In cutaneous lesions of patients with SLE, the lupus band test is positive in 90 to 100%. IgG, IgM, IgA, C3, and fibrin are most often detected. Most importantly, the LBT is positive in 50 to 90% in nonlesional, sun-protected skin of patients with SLE. In lesional skin of DLE, immune deposits are present in about 60 to 95% Lupus can also affect the skin and cause a rash or One way to make that diagnosis is through a biopsy, Research from the past year provides a more accurate estimate of lupus prevalence. Very accurate: A biopsy that is properly done is very accurate, and you should have great confidence in your diagnosis. But, it is only accurate for the exact time.. Lupus is an autoimmune disease that causes inflammation in the body, leading to a variety of symptoms and complications, ranging from rash to kidney failure. Fortunately, early diagnosis and.

Lupus diagnosis - biopsies. A biopsy involves removing tissue from a living body and examining it. In this case, therefore, it refers to removing tissue from a patient's body. Skin biopsy. If a patient has rashes or sores on their face, chest, scalp, or arms, they have cutaneous lupus. Cutaneous refers to the skin THE SKIN BIOPSY is an essential tool for the management of skin conditions. Performed properly, it can help establish a diagnosis and guide appropriate treatment. The treating clinician can dramatically improve the diagnostic accuracy of biopsy specimens by: • choosing optimal biopsy site • performing correct biopsy techniqu a biopsy of the skin, kidneys, or both There is no single test that can diagnose lupus. Instead, doctors must look at the results of several different tests and consider the person's symptoms Lupus mastitis is an infrequent sequela of the autoimmune disease Systemic Lupus Erythematosus (SLE) which can be confounding to both clinicians and diagnosticians due to its similar appearance to an infectious or even neoplastic process. This case demonstrates a patient who presented with a painful and edematous breast that was initially concerning for mastitis or underlying abscess on the. Patients with lupus may suffer other skin problems which are not specific to lupus, such as vasculitic rashes, blisters, leg ulcers and prickly heat. A skin biopsy is sometimes required to help make an accurate diagnosis. The following advice is recommended for lupus patients who are photosensitive to prevent flares wherever possible is as follows

what does a positive skin biopsy for lupus mean Answers

The sample can be obtained with a needle or through a small incision. Skin biopsy is sometimes performed to confirm a diagnosis of lupus affecting the skin The skin biopsy is a simple but essential clinical skill of the general practitioner. Performed properly, it can be quick and comfortable for the patient, and yield a very high level of diagnostic information. Performed incorrectly, it can lead to delays in diagnosis and treatment for the patient This disease can be diagnosed by taking a skin biopsy of the patch. The skin biopsy will show whether it is discoid lupus erythematosus or not. If the biopsy gives discoid lupus erythematosus, then additional blood testing is required. The accurate cause is not known, however, it is conceived to be an autoimmune disease Reasons and Results For Lupus Band Test. Submitted on March 27, 2012. Tweet. A lupus band test is a skin test done on a sample of skin biopsy. The method of testing used for this is direct immunofluorescence staining. Lupus basically denotes a group of skin disorders in which there are characteristically eroded lesions on the skin If the skin biopsy confirms the diagnosis, a muscle biopsy may be unnecessary. It is important to note that the skin biopsy for dermatomyositis and Lupus can appear identical under a microscope. Having an experienced dermatologist or rheumatologist is helpful when interpreting the results of the biopsy together with clinical features

Lupus band test is done upon skin biopsy, with direct immunofluorescence staining, in which, if positive, IgG and complement depositions are found at the dermoepidermal junction.: 212 This test can be helpful in distinguishing systemic lupus erythematosus (SLE) from cutaneous lupus, because in SLE the lupus band test will be positive in both involved and uninvolved skin, whereas with cutaneous. A tell-tale sign of lupus is a butterfly-shaped rash across the cheeks and bridge of the nose. Other common skin problems include sensitivity to the sun with flaky, red spots or a scaly, purple. Take the Lupus Quiz. Lupus is an autoimmune disorder that affects the whole body. It is also called systemic lupus erythematosus, or SLE. It can range from mild to severe. The Lupus Foundation of America says that as many as 1.5 million Americans have lupus. Most of them are women. Find out more about this disease by taking the following quiz. 1

The kidney biopsy is the gold standard for the diagnosis of lupus nephritis, Dr. Moeckel says. Though lupus causes uncomfortable and debilitating symptoms, many people live a long time with the disease. But when the inflammation spreads to the kidneys, it is a sign that the disease is accelerating and becoming more destructive During your visit with a doctor, they will conduct a physical examination. They will also run some useful tests to reach accurate diagnosis. Antibody testing is useful to diagnose the condition, but a skin biopsy is diagnostic of cutaneous lupus erythematosus. Treatment of cutaneous lupus. The main aims of treatment for cutaneous lupus are to

Which skin biopsy findings suggest systemic lupus

Thus, the DIF is most helpful if there is suspicion for cutaneous lupus and the biopsy is not diagnostic. A lupus band test, done on unaffected, non-sun-exposed skin, is mainly of historic interest. Prior to the current lupus serologic tests, the lupus band test was used to help make a diagnosis of systemic lupus erythematosus (SLE). Skin. Discoid Lupus Erythematosus (DLE) is an autoimmune condition that cases skin sloughing particularly around the nose causing scabbing and erosions that can become infected with bacteria. It can also affect the ear flaps, genitals and rarely spread through the entire body. DLE is diagnosed by submitting skin biopsies of affected areas for histopathological analysis The facial rash is often confused with other skin conditions, such as rosacea, a disorder that causes redness of the face, or psoriasis, which may lead to rashes and lesions anywhere on the body. Subacute Cutaneous Lupus. Subacute cutaneous lupus may be a sign of systemic lupus, but it can also develop on its own

Diagnosing Cutaneous Lupus NYU Langone Healt

  1. es Accuracy. Elmore's study of the variability in melanoma diagnostic findings was published in the British Medical Journal. The study began with 240 skin biopsy slides ranging from a normal mole to invasive melanoma. Each of the skin biopsy slides was first interpreted by a panel of experts independently
  2. A skin biopsy can also be used to confirm that a skin tumor is benign or to diagnose inflammatory skin conditions such as a drug-related rash or eczema. Below, Yale Medicine dermatologist Jean Bolognia, MD, and dermatopathologist Jennifer McNiff, MD, explain what you need to know before having a skin biopsy
  3. April 1, 2021. (ProNewsReport Editorial):- Dallas, Texas Mar 31, 2021 (Issuewire.com) - PERFORMING SKIN BIOPSIES: MAXIMIZING ACCURACY; MINIMIZING RISK. Clay J Cockerell, MD. The skin biopsy is one of the most commonly performed procedures in dermatology. Samples of skin are usually taken for routine microscopy, and immunofluorescence.
  4. ation, and clinical findings are comprehensively reviewed and diagnosed through blood, urine, and imaging tests as well as organ biopsy. There is no concept of a cure for lupus yet

Skin is commonly affected by vasculitic process and often subjected to biopsy. Cutaneous vasculitis can be either primary or part of a systemic vasculitic process. This study was conducted to evaluate the diagnostic utility of direct immunofluorescence (DIF) in determination of etiology of cutaneous Lupus and dermatomyositis H&EdPunch biopsy of an established lesion ([6 months old) that is still active DIFdPunch biopsy of lesional skin; choose an established lesion ([6 months old) that is still active SJS/TEN vs SSSS Shave or punch biopsy including the full thickness of the epidermis Desquamating sheets of skin may constitute an adequate. The role of skin biopsy Few vasculitic syndromes have pathognomonic clini-cal, radiographic and ⁄ or laboratory findings; thus, confident and accurate diagnosis of vasculitis requires histological confirmation. On the other hand, a biopsy diagnosis of vasculitis cannot stand alone, as it must b Site of biopsy. The optimal site for taking a biopsy of the skin depends on the suspected disease.. Autoimmune bullous diseases: take normal-appearing perilesional skin less than 1 cm from a bulla.As false-negative results may arise from samples from the lower extremities, avoid these sites if possible Both cause skin rashes, though lupus also affects the internal organs. a person should make sure they give an accurate history when a doctor or dermatologist asks. A skin biopsy involves.

Accurate histological diagnosis, although it can sometimes be difficult to establish, is essential for clinical management. in achieving the diagnosis. The patient's age and relevant clinical history, in addition to the site from which the skin biopsy was obtained, should be provided to the pathologist. lichenoid lupus erythematosus. Systemic lupus erythematosus (SLE) is a systemic autoimmune disease, with multisystemic involvement. The disease has several phenotypes, with varying clinical presentations in patients ranging from mild mucocutaneous manifestations to multiorgan and severe central nervous system involvement. Several immunopathogenic pathways play a role in the development of SLE

Lupus and your skin: Diagnosis and treatmen

  1. Essential to a logical therapeutic strategy is accurate diagnosis and subclassification. With respect to the foregoing, a thorough knowledge of clinical manifestations and serology is essential. A skin biopsy for routine histology, as well as the application of direct immunofluorescence microscopy to lesional and/or non-lesional skin, can be a.
  2. A skin biopsy can also help confirm a diagnosis of lupus when it affects the skin. If your doctor suspects or confirms SLE, you will likely be referred to a rheumatologist . This is a doctor who specialists in the treatment of joint diseases and autoimmune diseases
  3. Antibodies to Ro, a 60 KDa RNA binding protein, occur in up to 50% of lupus patients, especially in the presence of leukopenia, congenital heart block and photosensitive skin rashes. Antibodies to the 48KDa La antigen occur in 10-15% of lupus patients and predict late onset lupus, but are rarely seen in the absence of anti-Ro

If chemistry testing indicates kidney involvement, kidney biopsy may be performed to determine the presence of lupus nephritis. It is not absolutely accurate, but it helps determine treatment Some of the symptoms it has in common with lupus include swollen lymph nodes, muscle pain, joint pain, fever, and, less often, an enlarged spleen and liver. Serum sickness: Overlapping symptoms between serum sickness, an allergic reaction to an injected drug, and lupus may include swollen lymph nodes, skin lesions, fever, and joint pain. It actually says on the report there's evidence against Psoriasis!!! I've seen two Derm and countless GPs. 1 Derm said it was eczema cause of the biopsy report and the other said it was psoriasis. All GPs said, well the biopsy shows it eczema. By how the lesions react, look and feel, it appears to be psoriasis Others may also have a condition known as subacute cutaneous lupus, which causes red, scaly lesions on the skin that can be triggered or worsened by exposure to sunlight. Occasionally, the inflammation of Sjogren's syndrome affects the brain and nerves, as well as the kidney, liver, lungs, or esophagus In 110 cases, negative DIF results helped to rule out immune-mediated vesiculobullous disorders, lupus erythematosus and vasculitis, and the final diagnosis was made on the basis of the clinical features and/or histopathology. Conclusion: Direct immunofluorescence is a useful supplement for the accurate diagnosis of immune-mediated.

Why are Skin Biopsies Performed?

Immune & Autoimmune - Lupus: Will skin biopsy help with

Lab Tests for Lupus Lupus Foundation of Americ

The accurate diagnosis of any skin lesions can be made by histologic examination of a skin biopsy. However, clinicians must gain the clinical acumen to correctly identify common benign skin. Skin biopsy. If the doctor thinks that a suspicious area might be skin cancer, the area (or part of it) will be removed and sent to a lab to be looked at under a microscope. This is called a skin biopsy. If the biopsy removes the entire tumor, it's often enough to cure basal and squamous cell skin cancers without further treatment When I had my skin biopsy at mayo, they said it was granuloma annulare and first of all, the rash is not on my hands, wrists, ankles or feet which is most common in GA. And it is not circular in any way and looks nothing like the pictures I have seen of GA. They say lupus and lyme are both great imitators and it looks like I could have either Mobile Alabama Dermatologist Doctors physician directory - During a skin biopsy, a piece of skin is removed under a local anesthesia and examined using a microscope. The different types of skin biopsy include shave biopsy, punch biopsy, and excisional biopsy. Skin biopsies are performed to diagnose skin growths, skin conditions, and skin cancers We got the biopsy results and it said psoriasis. I asked her how definitive the results were and her response to me was these things are really hard to understand just blowing me off. I know she was wrong about the mollescum (the rash on her body was 100% gone within 2 days) and the fact that she is actually just a PA makes me nervous

Of these patients, 17 also had a skin punch biopsy performed at the time of the renal biopsy. In addition to LN patients, 3 biopsy pairs of control skin and renal tissue were obtained from healthy individuals undergoing a nephrectomy for kidney transplant donation. for Cell suspensions from skin and kidney biopsies of the sam Take the Lupus Quiz. Lupus is an autoimmune disorder that affects the whole body. It is also called systemic lupus erythematosus, or SLE. It can range from mild to severe. The Lupus Foundation of America says that as many as 1.5 million Americans have lupus. Most of them are women. Find out more about this disease by taking the following quiz Achieving an OR greater than 1 indicates that LUPKYNIS is favored over placebo. Pure Class V was the least common, with 75 patients in both studies. The clinical trials were not powered to detect a significant difference between the two treatment arms by biopsy class. About Lupus Nephriti You answered. The correct answer is. Discoid lupus erythematosus is a form of lupus that affects only the skin. It causes a raised rash on the face and scalp. The rash areas may become thick and scarred. The rash may last only days, or remain for years. Certain medicines may cause symptoms similar to SLE

The damage starts in the small intestine; so the most accurate test with celiac (and the earliest indicator) is to literally have your stool (poop) tested for atrophied villi. An excellent lab is located in Dallas, TX Six patients were followed for variable periods. We conclude that lupus erythematosus profundus is a benign form of lupus, distinguishable by systemic manifestations, clinical evolution and resolution, and heterogeneity in clinical manifestations. A skin biopsy is necessary to make an accurate diagnosis. PMID: 11419017 [Indexed for MEDLINE. According to Dr. Donald Thomas, a physician who specializes in lupus, the only 100% accurate and quick way to diagnosis lupus is through a kidney biopsy if someone has kidney inflammation or a skin biopsy if someone has a specific lupus rash. Otherwise, physicians are stuck using the criteria listed below Direct immunofluorescence of the affected skin provided supportive evidence of cutaneous lupus in 60% of malar lupus rashes and approximately 50% of subacute cutaneous and discoid lupus rashes. This reaffirmed the poor sensitivity of immunofluorescence, compared with routine histology, in the diagnosis of lupus rashes

Linear IgA Dermatosis and Chronic Bullous Dermatosis of

The dermatopathology of a skin biopsy: histology and direct immunofluorescence are indistinguishable from idiopathic forms. Treatment of drug-induced lupus erythematosus The most important treatment is to stop the trigger drug as this leads to resolution of the symptoms and blood test abnormalities My dermatologist told me that my skin biopsy indicated possible lupus or dermatomyositosis but not definitively. He will be doing some other tests to make a definite determination. Are there any other possible benign, non-serious diagnoses that could cause the initial test to come back as possible for lupus and/or dermatomyositosis Many autoimmune skin conditions are diagnosed using direct immunofluorescence (DIF) for testing a skin biopsy sample. DIF is considered a gold standard for diagnosing several types of autoimmune skin disorders, including cutaneous lupus, ocular cicatricial pemphigoid, pemphigus, epidermolysis bullosa, and bullous pemphigoid Benjamin F. Chong, Victoria P. Werth, in Dubois' Lupus Erythematosus and Related Syndromes (Ninth Edition), 2019 Subacute cutaneous lupus erythematosus. SCLE was defined by Gilliam and Sontheimer in 1977 and is a distinct subset of CLE, having characteristic clinical, serologic, and genetic features. 15 SCLE is typically photosensitive, although the midfacial skin is usually spared, whereas.

A cutaneous nerve/skin biopsy is useful to diagnose the presence and stage the severity of such a neuropathy. This is a very simple procedure performed in the outpatient setting. It takes 10 to 15 minutes to complete. First, the skin is thoroughly cleaned and a small injection of a local anesthetic to numb the skin is made Most people with lupus have a positive ANA test (though a positive ANA can also indicate diseases other than lupus). The diagnostic process may also involve a urine test to check for kidney issues, or a biopsy of your skin or kidney to look for inflammation Muscle biopsy: In this test, a small piece of muscle tissue is removed for testing to determine the type of myositis present. In one study, biopsies revealed muscle cell damage in many individuals with lupus that did not show clinical symptoms. This suggests that muscle damage is happening to a greater degree than often appreciated There is no single test to diagnose lupus. It may take months or years for a doctor to diagnose lupus. Your doctor may use many tools to make a diagnosis: Medical history Complete exam Blood tests Skin biopsy (looking at skin samples under a microscope Kidney biopsy (looking at tissue from your kidney under a microscope)

Skin biopsy - Mayo Clini

Lupus band test for systemic lupus erythematosus. Biopsy non-exposed, non-lesional skin (preferably buttocks or thigh) Label as non-exposed, non-lesional Vasculitis. Biopsy the active border of a new lesion, ideally one that is less than 48 hours old; Do not biopsy ulcers or old lesions; if possible, avoid the distal lower extremitie Discoid Lupus Erythematosus, or DLE, is a chronic skin condition that causes sores, inflammation, and scarring, according to the American Osteopathic College of Dermatology. These sores or lesions appear red and inflamed with a scaly appearance. MORE: What causes lupus? If the condition's suspected, it's necessary to perform a skin biopsy. 'Discoid' lupus erythematosus is confined to the skin and is not associated with symptoms from other organs. Tests sometimes required include a skin biopsy (removing a small sample of skin for analysis under a microscope), bloods and a urine sample. This leaflet aims to provide accurate information about the subject and is a.

About Lupus Nephritis LN is a serious manifestation of SLE, a chronic and complex autoimmune disease. About 200,000-300,000 people live with SLE in the U.S. and approximately one out of three of. If it's on the skin, we can do a skin biopsy and send it to a pathologist to diagnosis. Similarly, if it's elsewhere in the body, we can collect a biopsy and have it sent to a pathologist. This is the most accurate approach. Through a scope or by inserting a needle through the back, we get a sample of the organ to send in for testing. Optical Biopsy. By Editorial Team. May 3, 2017. Some lesions are obviously suspicious for melanoma. Perhaps they have typical features of melanoma. Maybe they are obviously different from the normal lesions around them. In such cases, the decision to biopsy may be clear. A skin biopsy is necessary to diagnose skin cancer

In general, a biopsy extending to subcutis taken from the most tender, reddish or purpuric, lesional skin is the key to obtaining a significant diagnostic result. 2 The optimal time for skin biopsy is <48 h after the appearance of a vasculitic lesion. If the biopsy is poorly timed, the pathological features of vasculitis may be absent, a fact. Renal biopsy can give you an accurate judge. 2. The treatment of lupus nephritis is determined by renal biopsy. By pathological examination of the kidney, lupus nephritis can be divided into six types according to different pathological manifestations. Class I: Minimal mesangial lupus nephritis. Class II: Mesangial proliferative lupus nephriti Label as involved skin. Avoid ulcers, old lesions, and facial lesions, if possible. Uninvolved, non-exposed skin is the preferred site to detect a lupus band as may be found in systemic lupus erythematosus. Label as uninvolved, non-exposed skin. Pemphigus and Pemphigoid Groups: Biopsy erythematous perilesional skin or mucosa Many dermatoses mimic each other because the skin displays only a limited number of reaction patterns. 4 As a result, there is no single dermatologic hallmark of autoimmune disease, but identifying lesions can help to narrow the differential diagnosis. For example, crusting is seen with PF, depigmentation with discoid lupus erythematosus, 2 and open fistulas with panniculitis.

Skin biopsy. The study of the skin of the head is a sampling of tissue for histological analysis. Using a special needle, the doctor cuts out a piece of 2-4 mm, which after special treatment is studied under a microscope. The entire procedure is performed under local anesthetic, so the patient does not experience discomfort or pain Yet, when a skin biopsy is performed correctly, these samples can yield a wealth of information and, perhaps, hold the key to diagnosis. Perform skin biopsies in cases of suspected neoplasia, vesicular or ulcerative diseases, or unusual or atypical cases as well as in cases that have not responded to conventional trial therapy

Accurate diagnosis of basal and squamous cell carcinomas

Skin Biopsy : Hi, had a punch skin biopsy done on

In some cases, it is necessary to test a small sample of kidney tissue to determine what the best treatment might be. The sample can be obtained with a needle or through a small incision. Skin biopsy is sometimes performed to confirm a diagnosis of Lupus affecting the skin. Always talk with your Naturopathic doctor first. Alternative Medicine In order to provide you with an accurate diagnosis, your medical professional may also suggest: A urine test. Imaging tests, such as x-rays and echocardiograms. A biopsy of your kidneys to see if they have been damaged. Unfortunately, there is no known cure for lupus Skin biopsy. This can identify characteristic skin changes related to lupus, such as inflammation at specific skin levels and patterns of deposited antibodies. Kidney biopsy

Lupus Band Test - an overview ScienceDirect Topic

A skin lesion biopsy is a simple medical procedure in which a sample of your skin is removed and tested in a laboratory. The sample taken during a biopsy is often very small, sometimes the size of. Lupus pernio is a type of skin lesion in purplish color.Microscopic examination of skin specimen with lupus pernio shows granulomatous infiltration.lupus pernio is rare type of skin disorder. Lupus vasculitis. Lupus may affect blood vessels of eyes leading towards sudden loss of vision.Most common example of lupus vasculitis is retinal. Skin biopsy and the absence of direct immunofluorescence confirmed a skin manifestation of her previously Keywords: Sarcoidosis, Lupus, Chronic cutaneous lupus erythematosus, Discoid lupus, CCLE, DLE Background fluorescence that become essential for accurate diagnosis of CCLE. Conclusion Without a biopsy, one might be quick to diagnose.

Indian Journal of Dermatology, Venereology and LeprologyFollicular lymphoma infiltrating the skin | The BMJ

How to Identify Rashes and Other Lupus Skin Symptoms

Lupus, Systemic lupus erythematous (SLE) description. Systemic lupus erythematosus (SLE or lupus for short) is an autoimmune disease that occurs when the body's immune system attacks its own tissues and organs causing severe inflammation of the joints, skin, kidneys, blood cells, brain, heart and lungs This is a particularly invasive form of testing, and because of that, there is a great deal of current medical research going into developing blood and urine tests that could give good accurate enough results so that there might be less of a need for kidney biopsies. Some Questions to Ask After a Lupus Diagnosi Background: Accurate diagnosis of skin disorders is of utmost importance as treatment is varied for different skin disorders presenting with the similar clinical lesions. Thus biopsy becomes inevitable in various skin disorders to confirm diagnosis and initiate treatment. The present study was to analyse the age and sex distribution o

How accurate is a biopsy Answers from Doctors HealthTa

Dermatitis herpetiformis (DH) is an intensely itchy skin disease. It causes clusters of small blisters and bumps. It typically affects people in their 30s to 50s, but it can happen at any age. This lifelong condition affects more men than women The most accurate response from the nurse is: Systemic lupus erythematosus (SLE) A patch test is a skin test that involves the administration of an allergen to the surface of the skin to identify specific allergies. A biopsy would provide a cytological examination of tissue. In a Wood's light examination, the skin is viewed under.

Lupus Nephritis,Symptoms,Treatments, Life Expectancy andDermatopathology | University Hospitals of Cleveland

Linear cutaneous lupus erythematosus (LE) is an unusual form of LE-specific cutaneous condition, occurring in children and young adults. Due to its rarity, the diagnosis of linear cutaneous LE can be difficult and facial lesions can resemble linear morphea or en coup de sabre. Differential diagnosis of similar conditions along the lines of Blaschko must be differentiated from linear LE Skin biopsy extending into the subcutis, identifying the dominant inflammatory cell and caliber of vessels affected, extravascular histologic clues such as presence of lichenoid dermatitis or panniculitis, and correlation with clinical data allows for accurate diagnosis of these uncommon vasculitic entities Some cases of lupus are isolated to the skin, most commonly discoid lupus erythematosus (DLE), and some rashes associated with lupus can resemble PN. These PN-resembling lupus rashes are distinct from the cardinal butterfly lupus-associated rash occurring outside of the face and characterized by thick and scaly patches that can itch