1979
DOI: 10.1001/archderm.115.12.1427
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Herpetiform blisters in systemic lupus erythematosus

Abstract: Four patients with systemic lupus erythematosus (SLE) had a vesicobullous eruption that histologically resembled dermatitis herpetiformis. Immunofluorescence microscopy patterns in the skin studied in three patients, however, were characteristic of SLE. Treatment of the underlying collagen-vascular disease improved the eruption, while recurrence coincided with exacerbation of the systemic disease. This distinctive lesion is an important parameter of SLE activity.

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Cited by 17 publications
(6 citation statements)
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“… 41 Primary histopathologic changes in BLE occurred in the DEJ and dermis, which included acute inflammation, interface change, intense leukocytoclastic hydropic basal degeneration, mucin deposition, and neutrophilic microabscesses at DEJ. 24 , 42 , 43 Neutrophils were the dominant cellular infiltrates in the DEJ in our patients. However, lymphocytic and eosinophilic infiltrates were also present in 25% of cases ( Table 2 ; Figure 5 ).…”
Section: Discussionmentioning
confidence: 49%
“… 41 Primary histopathologic changes in BLE occurred in the DEJ and dermis, which included acute inflammation, interface change, intense leukocytoclastic hydropic basal degeneration, mucin deposition, and neutrophilic microabscesses at DEJ. 24 , 42 , 43 Neutrophils were the dominant cellular infiltrates in the DEJ in our patients. However, lymphocytic and eosinophilic infiltrates were also present in 25% of cases ( Table 2 ; Figure 5 ).…”
Section: Discussionmentioning
confidence: 49%
“…Namely, a vesiculobullous lesion can develop when there is no clinical evidence of a worsening of SLE (7) or no laboratory evidence indicating the activity of SLE as revealed by urine protein excretion, high titer of anti‐double stranded DNA antibodies or significant hypocomplementemia (8, 25). However, in some cases, the flare apparently has coincided with the activity of SLE (5, 2528, 30). In fact, Malcangi et al reported that the bullous eruption was associated with a clinical and/or serological flare of the disease in 9 of 35 (26%) of cases (29).…”
Section: Discussionmentioning
confidence: 99%
“…Bullous systemic lupus erythematosus (BSLE) is a rare subset of SLE; it is comprised of a generalized vesiculobullous eruption characterized by subepidermal blistering and a neutrophil‐predominant dermal infiltrate (1, 2). Historically, the bullous eruptions associated with SLE have been variously reported as bullous pemphigoid associated with SLE (3), co‐existence of bullous pemphigoid and SLE (4), herpetiform blisters in SLE (5), or simply bullous dermatosis and SLE (6) and bullous eruption of SLE (7). The criteria for BSLE were first proposed by Camisa et al(1) and revised by Gammon et al based on the discovery that some patients with BSLE have circulating antibodies directed against type VII collagen, the major component of anchoring fibrils and the epidermolysis bullosa acquisita (EBA) autoantigen (2).…”
Section: Introductionmentioning
confidence: 99%
“…This patient met the ARA criteria for the diagnosis of systemic lupus erythematosus (SLE), with non-deforming arthritis, pleurisy, non-scarring alopecia, leukopenia and thrombocytopenia, and haematuria and casts. SLE may have many clinical features but bullae are a rare clinical manifestation (Penneys & Wiley, 1979;Rothfield & Weissman, 1961). Possibly the acute withdrawal of corticosteroids in this patient led to the severe eruption.…”
Section: Discussronmentioning
confidence: 99%