A Rare Case of TEN-Like Acute Cutaneous Lupus

TEN-like acute cutaneous lupus erythematosus (ACLE) is a rare and life-threatening condition associated with systemic lupus erythematosus (SLE), characterized by vesiculobullous eruptions and extensive epidermal necrosis. A 32-year-old African female with a new SLE diagnosis developed a severe rash and systemic symptoms, initially treated with hydroxychloroquine and steroids. The rash, suspected to be TEN-like ACLE, was confirmed by skin biopsy. Treatment with high-dose intravenous methylprednisolone and Rituximab led to rapid improvement, although the patient required intensive care for skin denudation and infections. The case highlights the importance of timely diagnosis and aggressive treatment, with B-cell depletion therapies and high-dose steroids proving effective in managing severe acute cutaneous SLE. The patient eventually recovered well with ongoing immunosuppressive therapy.