Systemic Lupus Erythematosus Presenting With Bullous Lesions, Cutaneous Vasculitis and Laryngeal Ulcerations - A Rare Association

October 2022 in “ International journal of research in dermatology ”

Mrudula Pulletikurti, Krishna Gopal, P. V. Krishnam Raju, B. Rekha Rani

systemic lupus erythematosus bullous lesions cutaneous vasculitis hair loss autoantibodies ANA anti-ds-DNA anti-Sm subepidermal blisters neutrophils parenteral steroids dapsone SLE steroids

TLDR A woman with lupus had unusual symptoms like blisters, skin inflammation, and throat ulcers, which improved with steroid and dapsone treatment.

A 31-year-old female with systemic lupus erythematosus (SLE) presented with rare complications including bullous lesions in sun-exposed areas, cutaneous vasculitis on palms and soles, and laryngeal ulcerations. She had a history of photosensitivity and hair loss. Laboratory tests revealed significant anemia and high levels of autoantibodies (ANA, anti-ds-DNA, anti-Sm), supporting the diagnosis of SLE. Histopathology and immunofluorescence of a skin biopsy confirmed bullous SLE, characterized by subepidermal blisters with neutrophils. The patient showed a positive response to treatment with high-dose parenteral steroids and dapsone. Due to the high risk of renal involvement, she was referred to a nephrologist for ongoing care.

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