Systemic Lupus Erythematosus Associated with Erythema Multiforme-Like Lesions

Yachoui, Ralph; Cronin, Patrick M.

doi:10.1155/2013/212145

Cited by 9 publications

(12 citation statements)

References 8 publications

(11 reference statements)

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“…Rowell syndrome is characterized by the coexistence of lupus erythematosus, erythema multiforme-like lesions and characteristic immunological changes (positive tests for antinuclear antibodies, rheumatoid factor and anti-Ro/anti-La antibodies) ( 3 – 11 ). Until 2014, 37 cases of Rowell syndrome were reported in the literature according to the data published by Bhat et al ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

Drug-induced Rowell syndrome, a rare and difficult to manage disease: A case report

et al. 2017

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Rowell syndrome is defined as the association between lupus erythematosus, erythema multiforme-like lesions and characteristic immunological changes including positive tests for rheumatoid factor, speckled antinuclear antibody, positive anti-Ro or anti-La antibodies. The present report presents the case of a 45-year-old female patient who was previously diagnosed in January 2010 with terbinafine-induced subacute cutaneous lupus erythematosus and was admitted for a skin eruption consisting of erythematous-papular erythema multiforme-like lesions, primarily on the trunk and limbs. The associated symptoms consisted of fatigability, myalgia and gonalgia. In October 2015, the illness reoccurred ~1 week after the initiation of Helicobacter pylori eradication treatment. Anti-Ro antibodies, rheumatoid factor and antinuclear antibody tests were positive. Given the patient's medical history, clinical manifestations, and laboratory, histopathological and immunofluorescence microscopy findings, a diagnosis of Rowell syndrome was made. Systemic corticosteroids (methylprednisolone; 0.5 mg/kg/day) and immunomodulatory therapy (azathioprine; 50 mg/day) were administered with the associated medication (omeprazole, 20 mg/day; KCl, 1 g/day) and topical dermocorticoids (fluticasone propionate 0.05% cream; 1 application/day), with a favorable outcome. The major diagnostic criteria for Rowell syndrome are the presence of lupus erythematosus (acute, subacute or systemic), erythema multiforme-like lesions and positive testing for antinuclear antibodies. The minor diagnostic criteria for Rowell syndrome are chilblains, the presence of anti-Ro antibodies and positive testing for rheumatoid factor. A diagnosis of Rowell syndrome is made if the patient exhibits all major criteria and at least one minor criterion. The present case met all diagnostic criteria, excluding the presence of chilblains. Notably, in this case there was a co-occurrence of subacute lupus erythematosus and Rowell syndrome lesions, which was drug-induced.

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Section: Discussionmentioning

confidence: 99%

Drug-induced Rowell syndrome, a rare and difficult to manage disease: A case report

et al. 2017

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“…In previous reports, the terms bullous SLE and Rowell syndrome may have been used less specifically to describe any blistering dermatoses in SLE. 9,11,12 More recently, Rowell syndrome diagnostic criteria have been revised to clarify Rowell syndrome from other variants of LE and erythema multiforme (Table 3). 13 Similar to the 4 cases of TEN-like LE in adults presented by Ziemer et al, 14 our cases demonstrated clinical features of LE that led us to this diagnosis.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Toxic Epidermal Necrolysis-Like Cutaneous Lupus in Pediatric Patients: A Case Series and Review

Brandling‐Bennett

et al. 2016

Pediatrics

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Bullous eruptions in patients with underlying systemic lupus erythematosus (LE) can mimic toxic-epidermal necrolysis (TEN), a rapidly progressive mucocutaneous reaction usually associated with medication use. Differentiating between classic drug-induced TEN and TEN-like cutaneous LE is important but difficult. We report a series of 3 patients with pediatric systemic LE who were admitted with severe worsening of skin disease resembling TEN. However, the initial photo-distribution of the eruption, subacute progression, limited mucosal involvement, mild systemic symptoms, supportive biopsy and laboratory results, and lack of culprit drugs was more suggestive of a TEN-like cutaneous LE. These patients recovered with various systemic immunosuppressive medications including methylprednisolone, intravenous immunoglobulin, and plasmapheresis. Our cases are rare and demonstrate key clinical and histologic features of TEN-like cutaneous LE in young patients and the importance of differentiating this entity from drug-induced TEN.

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“…'nın 4 kadın hasta üzerinde tanımladığı, uzun süreli diskoid lupus eritematozus (DLE), pernio ve EM benzeri lezyonlarının beraber bulunduğu, laboratuvar testlerinden benekli paternde ANA pozitifliği, RF pozitifliği, anti-SJT günümüzde anti-RO ve pansitopenin eşlik ettiği bir sendromdur 1 . Tanımlandığı günden sonra sistemik ve kutanöz LE ile EM benzeri lezyonların birlikteliği de tanı kriterlerini tam olarak sağlamasa bile RS olarak anılmıştır [2][3][4] . Günümüzde RS'nin ayrı bir antite, LE ile EM'nin tesadüfi birlikteliği veya subakut kutanöz LE'nin bir alt tipi olduğuna dair farklı görüşler vardır.…”

Section: Discussionunclassified

“…Günümüzde RS'nin ayrı bir antite, LE ile EM'nin tesadüfi birlikteliği veya subakut kutanöz LE'nin bir alt tipi olduğuna dair farklı görüşler vardır. Tanımlandığından günümüze kadar literatürde RS olarak veya LE/EM-benzeri lezyonların birliktelik gösterdiği olgular ve LE ile ilişkili Steven-Johnson/Toksik epidermal nekroz olguları bulunmaktadır [2][3][4] . Bu olgularda deri lezyonları genel olarak 2 gruba ayrılmıştır.…”

Section: Discussionunclassified

A case of systemic lupus erythematosus exacerbated with erythema multiforme-like lesions

Özcan¹,

Arısoy²,

Aytekin³

et al. 2015

TURKDERM

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The association of lupus erythematosus (LE) and erythema multiforme (EM) in the presence of anti-nuclear antibodies (ANA), Sjogren syndrome antigen B (autoantigen La) (anti-SS-B/La) and rheumatoid factor (RF) positivity has been described as a new syndrome by Rowell et al. in 1962. In 2012, Torchia et al. suggested novel diagnostic criteria for Rowell syndrome (RS). However, a number of cases, which lack the full diagnostic criteria, have been reported as RS in the literature. The EM-like lesions seen in these cases have been proposed as a subtype of subacute cutaneous LE. This article presents the case of a 34-year-old female patient with histopathologically diagnosed discoid LE, EM-like lesions, and speckled-pattern ANA positivity. Localizations of malar rash, discoid rash and EM-like lesions were not typical in the patient, and there was no triggering factor. Due to the lack of fully novel diagnostic criteria for RS, we conclude that our case is an instance of SLE exacerbated with EM-like lesions. (Turkderm 2015; 49: 85-8)

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Systemic Lupus Erythematosus Associated with Erythema Multiforme-Like Lesions

Cited by 9 publications

References 8 publications

Drug-induced Rowell syndrome, a rare and difficult to manage disease: A case report

Drug-induced Rowell syndrome, a rare and difficult to manage disease: A case report

Toxic Epidermal Necrolysis-Like Cutaneous Lupus in Pediatric Patients: A Case Series and Review

A case of systemic lupus erythematosus exacerbated with erythema multiforme-like lesions

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