As with many systemic lupus (SLE) complications, the patient with discoid lupus (DLE) is often best managed by a rheumatologist in tandem with a specialist of that complication, in this case, a good medical dermatologist experienced with cutaneous lupus. Although I think I am good at telling most ac...

If no clinical signs of disease activity (erythema, scale) for at least 6 months I would consider tapering therapy. If stable with topical therapy alone, would taper frequency of application to a few times weekly before discontinuation. If on systemic therapy and no new lesions or signs of clinical ...

Agreed! I also like to use 6 months of inactivity as the time to determine whether to taper. One other thing I sometimes do is step down the potency of the topical steroid if in remission or use tacrolimus instead to prevent flare ups, especially while tapering off of systemic therapy.