Bullous Lesions in Patients with Cutaneous Lupus Erythematosus: A Clinicopathologic Study

This retrospective study examined 14 cases (4.7%) of bullous lesions in cutaneous lupus erythematosus (CLE) out of 297 cases from 2016-2018. The study identified two distinct histologic patterns: lupus erythematosus-specific bullous lesions and bullous lupus erythematosus (BLE). The former showed exaggerated alterations in CLE lesions, while the latter was characterized by neutrophil collections at the base of bullae. BLE cases had higher rates of extracutaneous manifestations, renal involvement, and serologic positivity for antinuclear antibodies and double-stranded DNA. The study highlights the importance of distinguishing between these patterns due to their differing clinical implications and severity. Further multi-institutional studies with larger sample sizes are recommended to validate these findings.