What Is Your Diagnosis? Subacute Cutaneous Lupus Erythematosus

A 41-year-old man has a mildly pruritic rash spanning the central portion of the chest that has been present and unchanged for approximately 9 years. Prior treatments included oral cephalexin, topical antifungal agents, and topical steroid therapies without substantial improvement. Physical examination revealed large, annular, erythematous, scaly plaques with areas of hyperpigmentation forming concentric lesions on the mid chest wall.