Lupus Vulgaris Simulating Discoid Lupus Erythematosus

An 18-year-old woman reported with reddish, raised patches over the butterfly area of the face, extending to involve the nasal cartilage, upper lip, and medial canthii of both eyes. She was apparently well 2 years ago, when she noticed a small, pea-sized, raised, soft, reddish eruption over the right malar region. It was slowly progressive and enlarged over the period to involve the right malar region, the nose, upper lip, the opposite malar area, and the medial canthii of both the eyes. The lesions were asymptomatic; however, she experienced a foreign body sensation in her eyes, causing frequent lacrimation. There was no history indicative of systemic involvement. History of Bacillus-Calmatte-Guerin (BCG) vaccination was denied by the patient.