Anne - I have a good friend who has worked in a dermatologist's office for many years. But it wasn't until she saw a rheumatologist for various symptoms that she was advised to have a skin biopsy since she had some lesions on her face- and the biopsy did reveal the lupus. She has no scarring that I can see. I have been dx'd several times with actinic keratoses - all before autoimmune issues came to the surface- and had them removed via cryo (freezing) and surgically. I've had minimal scarring. I have a spot on my face that faded once I was on the Plaquenil, and now is returning with more sun exposure (even with sunblock). An old and wonderful doctor once told me the skin is one of the major organs and we need to pay much more attention to it. Just my 2 cents.