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Lupus erythematosus with antiphospholipid syndrome and erythema multiforme‐like lesions
Author(s) -
Marzano Av,
Emilio Berti,
Giovanni Gasparini,
Ruggero Caputo
Publication year - 1999
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1046/j.1365-2133.1999.03118.x
Subject(s) - erythema multiforme , medicine , anti nuclear antibody , lupus anticoagulant , antiphospholipid syndrome , partial thromboplastin time , pathology , antibody , rheumatoid factor , autoimmune disease , connective tissue disease , dermatology , immunology , autoantibody , platelet
The occurrence of erythema multiforme (EM) in patients with lupus erythematosus (LE) has been described previously as a coincidental association. In contrast, LE with EM‐like lesions and a peculiar immunological pattern, including positive rheumatoid factor, antinuclear antibodies and a serum antibody against an extract of human tissues recently recognized as similar to Ro (SSA), constitutes an established entity named Rowell's syndrome. We describe a woman with LE and long‐standing widespread vesiculobullous and necrotic haemorrhagic EM‐like lesions in combination with Ro (SSA) and scl‐70 antibodies and the typical laboratory findings of the antiphospholipid syndrome (APS), namely lupus anticoagulant, anticardiolipin antibodies and prolonged activated partial thromboplastin time. This case could conceivably be consistent with a diagnosis of Rowell's syndrome, if the latter is regarded as a clinicopathological spectrum. However, the coexistence of LE, persistent EM‐like disease and incomplete APS may also fulfil the diagnostic criteria for the ‘multiple autoimmune syndromes’. We speculate that the laboratory markers of APS play a pivotal part in such an unusual clinical presentation.