The histological features favor a diagnosis of erythema multiforme. La 6.065 high positive. Perniotic lesions with ulceration were seen on her fingertips. La 6.335 mid positive. The epidermis in areas shows some degree of basal degeneration and the upper dermis is edematous with an increase in vascularity and a patchy mild lymphohistiocytic infiltrate.
Some pigmentary incontinence is present.
No epidermal necrosis or isolated necrotic cells are identified. The histologic features are in keeping with a diagnosis of lupus erythematosus. Direct and Indirect immunofluorescence of lesional and normal skin was essentially non-specific. However the intervals between relapses are becoming longer.