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Discoid lupus erythematosus M029

Last amended 
9 April 2020
Current RMA Instruments
Reasonable Hypothesis SOP
126 of 2015
Balance of Probabilities SOP
127 of 2015
Changes from previous instruments

SOP Bulletin 186

ICD Coding
  • ICD-9-CM Codes: 695.4
  • ICD-10-AM Codes: L93.0
Brief description

Discoid lupus erythematosus is an autoimmune condition, related to systemic lupus erythematosus, but confined to the skin. It is a chronic, often scarring condition, commonly affecting the face and scalp.

Confirming the diagnosis

The diagnosis can be made on clinical grounds, but skin biopsy is usually necessary for confirmation.

The relevant medical specialist is a dermatologist. 

Additional diagnoses covered by the SOPs
  • Nil
Conditions not covered by these SOPs
  • Subacute cutaneous lupus erythematosis* (SLE SOP)
  • Systemic lupus erythematosis*

* Another SOP applies

Clinical onset

Once the diagnosis has been confirmed, the clinical onset can be dated from the first appearance of the characteristic, persisting skin lesions.  Any earlier skin rashes, that have since resolved, will not represent a clinical onset of discoid lupus erythematosus.

Clinical worsening

The condition tends to persist for years or decades but active disease can resolve in time.  Flare ups are possible, e.g. with sun exposure, but this may be a temporary, not a permanent worsening.  Permanent worsening beyond the normal course of the disease is required for clinical worsening factors to apply.