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

January 2021 in “ Journal of the American Academy of Dermatology ”

Vikarn Vishwajeet, Debajyoti Chatterjee, Uma Nahar Saikia, Rahul Mahajan, Bishan Dass Radotra, Sanjeev Handa, Dipankar De

cutaneous lupus erythematosus bullous lesions lupus erythematosus-specific bullous lesions bullous lupus erythematosus neutrophil collections antinuclear antibodies double-stranded DNA CLE BLE ANA dsDNA

TLDR Careful histologic examination is crucial to differentiate types of bullous lesions in cutaneous lupus erythematosus.

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.

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Most people with systemic lupus erythematosus have skin problems, and skin symptoms are often the first sign of the disease.