I thought it interesting as well, and would have welcomed a second biopsy to for complete confirmed. The idea that the first biopsy was "too superficial" and instead we are going with the histopath seemed a little puzzling.
I was just wondering how a visible area of atrophy is not seen under microscopy.But since the histopath was otherwise one had to settle to the results. Indeed the biopsy was more superficial than the atrophy.
Interesting indeed.Best wishes for speedy recovery. M.
Thank you for your reply. I spoke with my dermopathologist to get clarification on the matter. He said that he suspects degeneration of subcutaneous fat after reviewing the biopsy slide, and has considered another biopsy - as he believes the degeneration is deeper than where the first biopsy shows. He has decided against another biopsy at this time and for now I am to just begin treatment with Plaquenil and Locoid Lipocream. I go in for the eye exam tomorrow, and then I can start the Plaquenil.
Despite the clinical picture suggesting of panniculitis, the histopathologic feature show no evidence of lobular hyaline degeneration of subcutaneous fat, which is the main feature of LE Profundus.
Thus the diagnosis of Discoid LE stays, and then Discoid LE on the scalp can present atypical with focal alopecia.
Best wishes.