Bilaterally symmetrical lupus profundus with livedo reticularis as a sole cutaneous manifestation in a case of systemic lupus erythematosus

A 31-year-old female diagnosed as a case of systemic lupus erythematosus (SLE) two years back with no cutaneous lesions, with lupus nephritis and anti-ds DNA positivity presented with the hardness of skin over the inner aspect of both thighs for four months associated with mild pain and itching. Lupus profundus was diagnosed clinically and histopathologically. She had livedo reticularis over the left leg, which can be a sign of the central nervous system's future involvement. The recent development of bilaterally symmetrical lupus profundus over thighs and livedo reticularis in a case of SLE with lupus nephritis diagnosed two years back is a rare presentation.