From Prescription to Predicament: A Case of Semaglutide-Induced Discoid Lupus Erythematosus in an Adult Male Patient
Bibliographic record
Abstract
We report the case of a 30-year-old male patient who presented with a pruritic, irregular, 4x3 cm scaly purple-red plaque with surrounding papules on his lateral face, scalp, and chin after the introduction of semaglutide (Ozempic). Discoid lupus erythematosus (DLE) was suspected. A punch biopsy of a scalp lesion showed interface changes with loss of pilosebaceous units and follicular plugging, findings consistent with DLE. A complete blood count, antinuclear antibody (ANA), anti-double stranded DNA (dsDNA), and extractable nuclear antigen (ENA) panel was quantified along with erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), complement levels, creatinine, and glomerular filtration rate, ruling out systemic lupus erythematosus (SLE). The patient's condition improved with drug discontinuation as well as topical treatment, including tacrolimus 0.1% ointment and clobetasol lotion. Hydroxychloroquine 200 mg daily was trialed but discontinued due to the patient's concerns about ocular side effects. Follow-up after four months showed improvement, with less scale and erythema. Although semaglutide has been widely used for glycemic control and weight loss, cutaneous adverse effects are seldom reported. This case highlights the potential for drug-induced cutaneous lupus erythematosus (DICLE) associated with immune-modulating medications such as semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".