Lupus Erythematosus Tumidus with Autoimmune Thyroid Dysfunction as the First Presentation of Systemic Lupus Erythematosus: A Case Report and Review of the Literature

This case report described a 29-year-old male who initially presented with lupus erythematosus tumidus (LET) and later developed autoimmune thyroid dysfunction (AITD) as the first signs of systemic lupus erythematosus (SLE). The patient had recurrent erythematous plaques, fever, and systemic symptoms, initially misdiagnosed as a periodontal abscess. Immunological tests and a skin biopsy confirmed SLE, and treatment with steroids, azathioprine, and hydroxychloroquine improved most symptoms. Persistent edema and other signs led to a diagnosis of hypothyroidism, confirmed by elevated TSH and reduced FT4 and FT3 levels, with significant improvement following levothyroxine treatment. This case underscored the importance of considering SLE in patients with LET and the potential for associated AITD, emphasizing early diagnosis to improve outcomes. The study did not receive specific funding and declared no conflicts of interest.