Rowell's Syndrome: The Two Sides of the Truth

Caleya, Juan Francisco López; Rodrigo, Laura Martín; Rodríguez, Pablo Gonzalvo; García, Yolanda Hidalgo

doi:10.1016/j.reumae.2015.11.016

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…Preeclampsia affects 16% to 30% of SLE pregnancy compared with 5% to 7% in healthy women. The high risk of preeclampsia in SLE pregnancy is compounded by the difficulty in differentiating it from lupus nephritis [8] .…”

Section: Discussionmentioning

confidence: 99%

Rowell syndrome in pregnancy: A diagnostic challenge

Jaryal,

Mahajan

2023

Int. J. Clin. Obstet. Gynaecol.

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Rowell syndrome is comprised of erythema multiforme-like lesions in association with lupus erythematosus along with serologies of speckled antinuclear antibodies, positive rheumatoid factor, positive anti-La/ anti-Ro and the clinical finding of chilblains. 1 Rowell syndrome is currently classified as a subtype of chronic cutaneous lupus erythematosus. 2 The majority of cases are seen in women aged 20-70 years. The ratio of affected women to men is 8:1. Indian patients have a median age of 23 compared to age 32 worldwide and are less likely to be discoid lupus. 3 We report a case of Rowell syndrome in pregnancy. A 29 year old primigravida at the period of gestation 15 weeks developed vasculitic lesions, erythema multiforme-like lesions in palms, soles, oral ulceration suggestive of LE lesions. She also had Alopecia universalis, Taenia corporaris and scabies masking the lesions of Rowell syndrome which was a diagnostic challenge. Laboratory investigations revealed ANA+1:640 speckled, Anti Ro+++, Anti La +++. The histology of the targetoid lesions was consistent with erythema multiforme. The patient was successfully managed on low-dose aspirin and hydroxychloroquine. Lesions showed significant improvement in one month. Early diagnosis, multidisciplinary team approach, and intensive monitoring during the antenatal period were key to the successful outcome of patient who had normal vaginal delivery of female child at term. This case reflects that we should suspect Rowell syndrome even in young patients without precipitating features and further cases must be reported to help increase knowledge of the pathophysiology of Rowell syndrome.

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Section: Discussionmentioning

confidence: 99%

Rowell syndrome in pregnancy: A diagnostic challenge

Jaryal,

Mahajan

2023

Int. J. Clin. Obstet. Gynaecol.

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“…Since 2011, there have been around 80 reported cases in the literature. 3 Although the age range of reported cases of RS is from the second to tenth decades of life, 4,5 the disease seems to exhibit a predilection for middle-aged women. 4 We describe a unique case of RS due to its occurrence in a middle-aged man and its recurrence initiated by ultraviolet (UV) exposure.…”

Section: Introductionmentioning

confidence: 99%

Rowell syndrome with recurrence from photoexacerbation: A case report

Alkul

Behrens

Stetson

2019

SAGE Open Medical Case Reports

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Rowell syndrome is a controversial entity composed of erythema multiforme-like lesions coexisting with lupus erythematosus. We describe a case of a 61-year-old male with a history of systemic lupus erythematosus who presented with photoexacerbated flaccid bullae and erosive plaques after repetitive sun exposure. Based on his clinical history, biopsy, and laboratory findings, he fulfilled diagnostic criteria for Rowell syndrome as described by Zeitouni et al. With oral prednisone, hydroxychloroquine, mycophenolate mofetil, and local wound care with petrolatum, the patient’s number of lesions decreased, as well as his pain and tenderness. He subsequently did not develop any new erosions. This case highlights the diagnostic criteria of this hybrid clinicopathological syndrome and its nature of photosensitivity.

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<p>A Case of Rhupus with Rowell Syndrome</p>

Almansouri¹,

Alzahrani²

2020

OARRR

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We report a case of 30-year-old female who presented initially with hair loss, photosensitive malar rash, morning stiffness and synovitis. She was diagnosed with Rhupus syndrome based on clinical and laboratory findings. Few months after starting hydroxychloroquine, esomeprazole and azathioprine, and failing methotrexate (because of erosive pillinduced esophagitis), she presented with generalized maculopapular dusky reddish rash in her body, back and extremities. Her anti-double stranded-DNA, anti-nuclear antibody, anti-Ro/SSA and anti-La/SSB were positive. Anti-cyclic citrullinated peptide antibody was moderately positive. She had low complements: C3 and C4. Herpes simplex IgM and mycoplasma tested negative. Skin biopsy from right arm showed evidence of erythema multiform. She met the criteria for the diagnosis of Rowell syndrome. We managed her with hydroxychloroquine, prednisolone, mycophenolate mofetil and topical agents and discontinued esomeprazole. We also review the management of Rowell syndrome in the literature.

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Rowell's Syndrome: The Two Sides of the Truth

Cited by 3 publications

References 11 publications

Rowell syndrome in pregnancy: A diagnostic challenge

Rowell syndrome in pregnancy: A diagnostic challenge

Rowell syndrome with recurrence from photoexacerbation: A case report

<p>A Case of Rhupus with Rowell Syndrome</p>

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