Systemic Lupus Erythematosus Appearing as an Urticarial Vasculitis

Abstract

A patient with systemic lupus erythematosus presented with clinical and histologic feature of urticarial vasculitis, a systemic immune disorder of unknown origin. This could represent a subset of collagen vascular disease.

Urticarial lesions: If not urticaria, what else? The differential diagnosis of urticaria

“…Among these, the most common are autoimmune connective tissue diseases (particularly SLE, 19,20,[48][49][50][51][52][53][54][55] but also systemic sclerosis, 56 GougeroteSjögren syndrome, 57 and paraneoplastic dermatomyositis 58 ), followed by infections (mainly chronic or acute viral hepatitis [59][60][61][62][63][64] and sporadic reports of EpsteineBarr virus, 65 Mycoplasma pneumoniae, 66 and Lyme disease 67 ) and inflammatory bowel diseases. 68 In some cases, UV can be a paraneoplastic manifestation, mainly associated with hematologic malignancies, including mostly non-Hodgkin B-cell lymphomas, 69-71 monoclonal gammopathies/myeloma, 72-74 anecdotal cases of Castleman disease, 75 and polycythemia rubra vera, 76 but also with various solid neoplasms (nonesmall cell lung cancer, 77 renal cancer, 78 testicular teratoma, 79 colon adenocarcinoma, 80 and nasopharyngeal carcinoma 58 ).…”

Systemic lupus erythematosus presenting with normocomplementemic urticarial vasculitis in a 4‐year‐old girl

“…1 Urticarial vasculitis has been previously described in SLE, both a disorder progressing to SLE and as the presenting sign of SLE. 5,6 However, when HUV was compared with NUV for specific clinical, histologic and immunologic findings, SLE was found to be associated with HUV rather than NUV. 1 In that study, only 3% of patients with NUV met the criteria for a diagnosis of SLE, whereas 54% of patients with HUV were also diagnosed as SLE.…”

Vitiligo associated with malignant melanoma and lupus erythematosus

“…However, when urticaria exists as a manifestation of SLE, vasculitis and hypocomplementemia may also be observed. [6][7][8] Up to now, malignant melanoma, vitiligo, SLE and idiopathic urticaria have not been reported in the same case.…”

“…There exists several reports where malignant melanoma is associated with vitiligo, vitiligo with discoid lupus erythematosus (DLE) and lupus erythematosus with urticaria. [1][2][3][4][5][6] However, there are no reports in which vitiligo, malignant melanoma, lupus erythematosus and urticaria coexist in the same case. Herein, we are presenting such a case, of a unique patient suffering from lupus erythematosus, vitiligo, malignant melanoma and urticaria simultaneously.…”

“… ABSTRACT There exists several reports where malignant melanoma is associated with vitiligo, vitiligo with discoid lupus erythematosus and lupus erythematosus with urticaria 1–6 . However, there are no reports in which vitiligo, malignant melanoma, lupus erythematosus and urticaria coexist in the same case.…”