Trichoscopy and Histopathology of Follicular Keratotic Plugs in Scalp Discoid Lupus Erythematosus

Dermoscopy has become an integral part of diagnosing scalp disorders including discoid lupus erythematosus (DLE). Follicular keratotic plugs are a marker of DLE and correlate with the hyperkeratosis and plugging of the follicular ostia with keratotic material. They may be present in acute or chronic lesions and their presence alone or in conjunction with other described dermoscopic features can lead to timely diagnosis and initiation of treatment. We present three cases of scalp DLE and discuss the clinical, dermoscopic and histopathologic features.