“…Bullae can be seen in chronic discoid LE [12] as well as in systemic LE [11,[14][15][16]. In the patient described here, the initial blisters manifest the characteristics of the bullae of EEM.…”
Section: Discussionmentioning
confidence: 80%
“…In the patient described here, the initial blisters manifest the characteristics of the bullae of EEM. However, such a picture rarely occurs [14,15]. The diagnosis is difficult because the early lesions do not suggest systemic LE either on clinical, or on histological grounds.…”
“…Bullae can be seen in chronic discoid LE [12] as well as in systemic LE [11,[14][15][16]. In the patient described here, the initial blisters manifest the characteristics of the bullae of EEM.…”
Section: Discussionmentioning
confidence: 80%
“…In the patient described here, the initial blisters manifest the characteristics of the bullae of EEM. However, such a picture rarely occurs [14,15]. The diagnosis is difficult because the early lesions do not suggest systemic LE either on clinical, or on histological grounds.…”
“…L.E. cells were demonstrated in the fluid of these bullsB (Rothfield et al, 1961;Tromovitch et al, 1961). On rupture, shallow aseptic ulcers were formed.…”
Sixty two cases of SLE were studied in a Medicai Unit for a period of 4 years. Four different aspects of the cutaneous manifestations were analyzed and discussed. Butterfly rash, alopecia and photosensitive lesions were slightly more common than in Western series, whereas, Raynaud's phenomenon, discoid lesions and others were rarely found. Some other uncommon lesions, especially one case with bullae formation, one with gangrene of toe and another with subcutaneous calcinosis, were observed. Psoriasiform lesions and hyperkeratotic lesions were also found in this series.Skin lesions secondary to systemic disorders and therapy were also studied and the findings discussed.
“…The histologic examination of the lesion revealed bullae containing polymorphonuclear cells and some lymphocytes. But in that time, DIF method was not available, and so it could not be performed as well [26]. Also, the first well-documented cases of BSLE were published by Hall et al [27].…”
Bullous systemic lupus erythematosus is a rare distinctive subepidermal bullous disease seen in patients with systemic lupus erythematosus (SLE). It has characteristical clinic, pathologic, and immunologic findings including antibodies to type VII collagen, laminin 332, laminin 331, and bullous pemphigoid antigen 230. Clinical presentation combined with histopathology, immunological testing, and concomitant diagnosis of SLE according to the criteria of American College of Rheumatology, are required to distinguish bullous SLE from these bullous diseases. In patients with bullous SLE, SLE disease progression and complications may be worse. Cicatricial pemphigoid is a chronic subepidermal blistering disease which is characterized by erosive lesions of mucous membranes and skin. Pathogenesis of cicatricial pemphigoid is characterized by linear deposition of Immunoglobulin G, A, or complement 3 along the epithelial basement membrane zone. The main target antigens are bullous pemphigoid antigens 180-230, laminin 331-332, type VII collagen, and β-4 integrin subunit. Cicatricial pemphigoid may lead to serious complications such as blindness and airway obstruction. Herein, clinical, histological, immunopathological features, the diagnosis and treatment of bullous SLE and cicatricial pemphigoid diseases are mentioned to raise awareness among the dermatologists about this important but rare heterogeneous bullous disease.
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