TNF and discoid lupus erythematosus: In addition to solar radiation, DLE lesions can be caused by trauma, which constitutes the Koebner phenomenon.2, 3, 30 Drug-induced DLE is very rare, with sporadic reports associating it with leflunomide, 5-fluoruracil, capecitabine, palbociclib, pembrolizumab and most commonly with anti-TNF agents.31