Tender, atrophic plaque on the arm and chest

A black woman, aged 37 years and previously diagnosed with systemic lupus erythematosus (SLE), presented with painful lesions on her right arm of four months' duration. Review of symptoms was remarkable for photosensitivity and joint pain.

Physical exam showed an atrophic tender plaque with overlying depigmentation on her right arm with similar lesions on her forearm and chest. An antinuclear ...