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A reddish brown plaque on the earlobe

BMJ 2023; 380 doi: https://doi.org/10.1136/bmj-2022-070758 (Published 19 January 2023) Cite this as: BMJ 2023;380:e070758
  1. Hu Honghua, dermatologist1,
  2. Ji Shunxian, pathologist2,
  3. Liu Lunfei, consultant dermatologist3
  1. 1Department of Dermatology, The Fourth Affiliated Hospital, Zhejiang University, School of Medicine, Yiwu, Zhejiang, China
  2. 2Department of Pathology, The Fourth Affiliated Hospital, Zhejiang University, School of Medicine, Yiwu, Zhejiang, China
  3. 3Department of Dermatology, The Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
  1. Correspondence to Hu Honghua drhuhonghua{at}zju.edu.cn

A man in his 50s presented to the dermatology clinic with an eight year history of a reddish brown plaque on his left earlobe. The plaque had previously been attributed to discoid lupus erythematosus (DLE), and the patient had received several treatments without improvement. He had no systemic symptoms, trauma history, BCG vaccination, or history of systemic tuberculosis. Examination found a well defined infiltrated erythematous plaque with overlying scale crusts and scarring of the ear lobe (fig 1). The concha of the ear was unaffected, and the patient had no lesions elsewhere. He had no regional lymphadenopathy.

Fig 1

A well defined infiltrated erythematous plaque with overlying scale crusts and scarring of the ear lobe

Laboratory investigations, including complete blood count, metabolic panel, anti-nuclear antibody, interferon γ release assay …

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