A Rare Case of TEN-Like Acute Cutaneous Lupus

TEN-like acute cutaneous lupus erythematosus (ACLE) is a rare and life-threatening condition seen in patients with systemic lupus erythematosus (SLE), characterized by vesiculobullous eruptions and extensive epidermal necrosis. This case report describes a 32-year-old African female with SLE who developed a severe generalized rash, initially treated with hydroxychloroquine and steroids. The rash evolved into painful bullae, leading to a diagnosis of TEN-like ACLE. Treatment with high-dose intravenous methylprednisolone and Rituximab resulted in rapid improvement, although the patient required intensive care due to severe skin denudation. The patient responded well to immunosuppressive therapy and has made a good recovery. The report highlights the importance of timely diagnosis and aggressive treatment, suggesting that B-cell depletion therapies and high-dose steroids are effective in managing severe acute cutaneous SLE.