We examined a patient with systemic lupus erythematosus and sepsis due to Pseudomonas aeruginosa. Early in the infection, she developed skin lesions that consisted of indurated tender nodules and hemorrhagic and nonhemorrhagic bullae. Blister fluid contained gram-negative rods, which were identified as P. aeruginosa on culture. Bullae and nodules, as well as ecthyma gangrenosum, can be early cutaneous signs of pseudomonal sepsis.
Two patients with bullous systemic lupus erythematosus are reported. In one, the disease appears to have been caused by hydralazine. The cutaneous lesions of bullous SLE have not been previously reported in drug-induced lupus.
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