Lupus Panniculitis Presenting as Multiple Discharging Sinuses

Lupus erythematosus profundus (lupus panniculitis) is an uncommon variant of panniculitis, which may present as localized entity or in association with systemic lupus erythematosus or discoid lupus erythematosus. Patients develop discrete, firm, asymptomatic, or painful nodules localized on the face, shoulder, arms, breast, and buttocks; the nodules are often associated with trauma. The overlying skin may appear clinically normal or show discoid lupus plaques, poikiloderma, erythema, atrophy, or ulceration. We report a case of biopsy-proven lupus panniculitis in a 21-year-old female presented with multiple discharging sinuses over her face and arms with scarring alopecia, treated with chloroquine and tapering doses of glucocorticoids. Lupus panniculitis just accounts for 1%–3% of lupus-specific skin changes. This case is being reported for its rarest presentation of lupus panniculitis as discharging sinuses.