A Diagnostic Conundrum: Unusual Presentation of Acute Cutaneous Lupus Erythematosus Mimicking Toxic Epidermal Necrolysis.

IF 1.3 Q4 RHEUMATOLOGY
Nilesh Kamble, Rajashree Khot, Saransh Barai, Sachin Chaudhari, Bharatsing Rathod, Onkar Awadhiya
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引用次数: 0

Abstract

Systemic lupus erythematosus (SLE) is an intricate autoimmune disorder with diverse clinical presentations, encompassing various cutaneous manifestations. This case report describes a diagnostically challenging occurrence of acute cutaneous lupus erythematosus (ACLE) exhibiting a toxic epidermal necrolysis (TEN)-like rash in a 28-year-old female already diagnosed with SLE. The patient's rapid progression from itching to maculopapular skin eruptions involving the face, extremities, and torso within days, coupled with facial puffiness and systemic symptoms, presented a clinical conundrum. Histopathological findings of epidermal hyperkeratosis, acanthosis, and a subcorneal neutrophilic abscess guided the exclusion of other conditions, emphasizing the distinctive features of TEN-like ACLE. The patient exhibited a favorable response to pulse methylprednisolone, mycophenolate mofetil, and hydroxychloroquine.

诊断难题:急性皮肤红斑狼疮的不寻常表现模拟毒性表皮坏死松解。
系统性红斑狼疮(SLE)是一种复杂的自身免疫性疾病,具有多种临床表现,包括多种皮肤表现。本病例报告描述了一个诊断具有挑战性的急性皮肤红斑狼疮(ACLE)的发生,表现为毒性表皮坏死松解(TEN)样皮疹,患者为28岁的女性,已被诊断为SLE。患者在数天内从瘙痒迅速发展为涉及面部、四肢和躯干的斑疹丘疹,并伴有面部浮肿和全身症状,这是一个临床难题。表皮角化过度、棘层增生和角膜下嗜中性脓肿的组织病理学结果排除了其他疾病,强调了ten样ACLE的独特特征。患者对甲强的松龙、霉酚酸酯和羟氯喹脉冲治疗有良好的反应。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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