Subacute cutaneous lupus erythematosus associated with breast carcinoma

Conflict of interest: none declared. A 67‐year‐old woman presented to our clinic in April 2008 for evaluation of an 8‐week history of a skin rash that initially started on her arms followed by involvement of the trunk and legs. In 1991, the patient had undergone wide local excision on the right breast followed by radiotherapy and tamoxifen for an invasive grade II ductal carcinoma. In 2005, she was diagnosed as having a recurrent metastatic breast carcinoma with involvement of lungs and bones, and was treated with hormonal therapy (letrozole; Novartis UK, Camberley, Surrey, UK). On physical examination, a nonscaly annular erythematous rash involving the trunk, shoulders, chest and forearms was found (Fig. 1a). The rest of the physical examination was unremarkable except for hepatomegaly. Histological examination of a skin biopsy found epidermal atrophy, basal cell vacuolar degeneration, follicular plugging, basement‐membrane thickening, and a mild chronic inflammatory infiltrate periadnexally and along the dermoepidermal junction, consistent with subacute cutaneous lupus erythematosus (SCLE) (Fig. 1b).