A 29-year-old Brazilian woman was referred for management of systemic lupus erythematosus (SLE) with antiphospholipid antibodies (aPL). Her symptoms were 1 year of intermittent fever and diffuse, tender, erythematosus, and nodular rash that began during her first pregnancy. She was treated with short course of lowdose corticosteroids, with resolution; however, she suffered an embryonic loss at 7 weeks. Six months prior to admission, she had recurrence of the nodular rash with new onset arthralgia; a skin biopsy showed panniculitis.