Discoid lupus erythematosus M029

Current RMA Instruments

Changes from previous instruments

ICD Coding

• ICD-10-AM Codes: L93.0

Brief description

Discoid lupus erythematosus is the most common form of chronic lupus erythematosus (CCLE). It is an autoimmune condition where the body's immune system mistakenly attacks the skin commonly leadingly to red, scaly plaques which often heal with scarring. The concha of the ear (bowel shaped part of the outer ear, before the ear canal), head or neck are often affected. 5-10% of people with DLE may eventually develop SLE. 

Confirming the diagnosis

The diagnosis can be made on clinical grounds by a dermatologist or rheumatologist, but skin biopsy is usually necessary for confirmation. Blood tests are commonly done to check for systemic involvement. 

Additional diagnoses covered by the SOPs

• Chronic Cutaneous Lupus Erythematosus (CCLE)
• Discoid Lupus 
• Cutaneous Lupus- Discoid type 

Conditions not covered by these SOPs

• Acute cutaneous lupus erythematosus # or * SLE SOP may apply 
• Chilblain lupus erythematosus #
• Lupus erythematosus- lichen planus overlap syndrome #
• Lupus erythematosus panniculitis #
• Lupus erythematosus profundus #
• Lupus erythematosus tumidus #
• Subacute cutaneous lupus erythematosus # or * SLE SOP may apply 
• Systemic lupus erythematosus *

* another SOP applies- the SOP has the same name unless otherwise specified

# non- SOP condition

Clinical onset

Once the diagnosis has been confirmed, the clinical onset can be dated from the first appearance of the characteristic, persisting skin lesions. 

Clinical worsening

Discoid lupus erythematosus often persists for years or even decades, though active disease may eventually resolve. Flare-ups can occur- e.g. following sun exposure- but these are typically temporary and do not represent a lasting change in the disease course. For a clinical worsening factor to apply, there must be evidence of permanent worsening beyond the expected normal course of the condition.