Systemic lupus eythematosus with toxic epidermal necrolysis-like presentation - case report

Drangoi Irina⁽¹⁾, Birzaneanu Anda^(1,*), Bita Elena Cristina^(1,2), Vreju Ananu Florentin^(1,2), Dinescu Stefan Cristian^(1,2)

1)Emergency County Hospital Craiova, Rheumatology Department, Craiova, Romania
2)University of Medicine and Pharmacy, Craiova, Romania

Systemic lupus erythematosus (SLE) is a rare autoimmune disease with a wide spectrum of clinical manifestations, among which the skin involvement is one of the most common forms of presentation. Skin lesions specific to SLE are classified as either acute, subacute or chronic. Nevertheless, SLE patients can develop rare atypical skin lesions at onset which may pose diagnostic challenges. Toxic epidermal necrolysis (TEN)-like lupus is a rare and severe form of skin involvement which may develop in SLE patients, either in the course of the disease, during an acute flare, or at first presentation. Although TEN-like lupus can mimic true drug-induced TEN/Stevens–Johnson syndrome, presence of additional lupus-related clinical, immunology and histopathology features should be considered when making a differential diagnosis. Prompt diagnosis and screening for systemic involvement is essential for optimal management of SLE patients. We present a case report of a female patient diagnosed with SLE which developed diffuse TEN-like lesions at disease onset with good outcome after high-dose glucocorticoid combined with immunosuppressive therapy.

Keywords: systemic lupus erythematosus, toxic epidermal necrolysis, Stevens–Johnson syndrome

Corresponding author(s): Birzaneanu Anda, Emergency County Hospital Craiova, Rheumatology Department, Craiova, Romania, email: andabirzaneanu@gmail.com