Abstract
M. K., a woman aged 48 years, a graduate nurse by profession, first consulted a dermatologist at the age of 25 because of a lesion on the left cheek. This was diagnosed at that time as chronic discoid lupus erythematosus and "confirmed by biopsy." She received, over a period of 20 years, various forms of conventional therapy for this condition, including injections of gold, bismuth, and liver extract, as well as various types of local therapy, including application of solid carbon dioxide. Her condition fluctuated in its severity, with periods of quiescence lasting several years, interrupted by flare-ups. She stated that these exacerbations were characterized by increased erythema and itching, with some scaling, but that at no time was there any elevation of the lesion above the surface of the skin. The usual appearance until the onset of the present complication was described by her as a flat

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