Takezawa K, et al. - In this study of a 34-year-old woman presented with hair loss to the parietal region and who had SLE, experts described discoid lupus erythematosus (DLE) on the scalp with a pathological variance of a xanthomatous reaction, which was successfully treated with hydroxychloroquine (HCQ). The individual started treatment with HCQ at a dose of 200 mg/day. Treatment with 30 mg/day of prednisolone (PSL) begun, and the dose was gradually decreased. The skin lesions completely settled within five months following the beginning of HCQ without an increase in the dose of PSL. In triggering the secondary reactive process of a xanthomatous reaction, the chronic epithelial injury in DLE could be involved. It was believed that the reaction observed in this individual was a secondary transition to pathological modification because of SLE. Nevertheless, as until unidentified, in the development of a xanthomatous reaction in DLE, factors may play a part.