The correct answer is D. Squamous cell carcinoma is a potential sequela.

This is an image of discoid lupus erythematosus (DLE). Squamous cell carcinoma may develop from lesions of DLE. SCCs are rare and aggressive tumors with greater likelihood of metastases. Cases have been reported among patients with different clinical characteristics. Classically, 5-15% of patients with DLE will eventually develop SLE. C2 (not C3) deficiency increases susceptibility to autoimmune conditions, particularly lupus (DLE, SCLE, SLE). Biopsy characteristically shows a thinned epidermis with plugged follicles, vacuolar degeneration of the basal layer, a thickened basement membrane, melanin incontinence, perivascular/periadnexal lymphocytes, and increased mucin deposition between collagen bundles. UV exposure exacerbates DLE, so UV protection is a critical aspect of treatment.

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