A case is presented of a 27-year-old Caucasian woman that presented with an oval purplish patch with defined borders on her right cheek. It was swollen and tense, with a mottled surface due to scarring. Histologic examination indicated discoid lupus erythematosus and the patient was initially treated with medical therapy. The lesion relapse and cosmetic results convinced us to propose surgical option with aggressive medical treatment and follow up. In our patient, this combination therapy proved effective.