Bullous systemic lupus erythematosus

✍ Scribed by Anthony Yung; Amanda Oakley

• Publisher: John Wiley and Sons
• Year: 2000
• Tongue: English
• Weight: 124 KB
• Volume: 41
• Category: Article
• ISSN: 0004-8380
• DOI: 10.1046/j.1440-0960.2000.00426.x

✦ Synopsis

SUMMARY

A 19‐year‐old woman with a 6 month history of systemic lupus erythematosus (SLE) developed a widespread urticated, erythematous eruption associated with tense, fluid‐filled blisters, erosions and crusting. Biopsy showed subepidermal blistering with a prominent neutrophilic infiltrate. Direct immunofluorescence showed markedly positive granular IgG deposition with weak IgM, IgA and C3 at the dermo‐ epidermal junction. No circulating antibodies were detected on indirect immunofluorescence. A diagnosis of bullous systemic erythematosus was made. Treatment with prednisone was ineffective. Subsequent treatment with dapsone led to rapid sustained remission of skin symptoms. Bullous SLE is a rare manifestation of SLE. We review the recent literature and discuss the distinctive features of this condition and contrast them with cutaneous SLE with blisters and the subepidermal blistering disorders.