Lúpus eritematoso sistêmico bolhoso em gestante: relato de caso*

Abstract

Systemic lupus erythematosus (SLE) can cause numerous skin lesions. Despite being rare, lupus-specific bullous lesions demonstrate characteristic clinical and immunopathological features and require differential diagnosis among numerous bullous conditions that may overlap with SLE. The present study presents a case of bullous systemic lupus erythematosus (BSLE) in a pregnant woman.

Treatment of Bullous Systemic Lupus Erythematosus

“…It has been reported that patients with BSLE, who initially presented with lesions clinically resembling erythema multiform, experienced exacerbation of their disease with dapsone [ 27 – 29 ]. Furthermore, dapsone has been assigned to pregnancy category C; BSLE patients with pregnancy might not be fit for administration of this drug [ 30 ]. Hemolysis and hepatic and renal toxicity usually accompany administration of the drug in a dose related fashion [ 31 – 34 ]; therefore its clinic use was confined and a careful monitoring of its toxicity is required.…”

“…A skin biopsy of this patient was performed, and it showed significant necrosis of keratinocytes in the epidermis and granular, dense, and continuous deposits of moderate IgG positivity in the basement membrane zone. Dapsone has been assigned to pregnancy category C. The pregnant woman treated with high-dose corticosteroids obtained a satisfactory response [ 30 ]. As the dapsone administration often causes hepatic and renal toxicity [ 32 , 33 , 38 – 40 ], prednisone alone or in combination with low doses dapsone might be the treatment of choice for these BSLE patients.…”