Lower eyelid involvement occurs in 6% of patients with discoid lupus erythematosus
(DLE). Eyelid lesions are rarely the initial manifestation of DLE. We describe a 25-yearold
woman presenting with discoid lesions of the lower eyelids, staphylococcal
blepharitis and Meibomian gland dysfunction, who later developed a discoid lesion on
the chin. Histopathological and immunofluorescence studies of a biopsy specimen from
this lesion established the diagnosis of DLE. We are unaware of any previously reported
cases of DLE presenting with discoid eyelid lesions associated with staphylococcal
blepharitis and Meibomian gland dysfunction. DLE should be considered as a differential
diagnosis in chronic blepharitis that persists despite usual medical management and
eyelid hygiene. Misdiagnosis may lead to eyelid margin deformities, necessitate a
complicated full-thickness biopsy, and delay diagnosis of systemic lupus